Individual
PHYLLIS HEREDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSA
Contact information
Practice address
7324 SW FREEWAY, SUITE 1550, HOUSTON, TX 77074-2053
(713) 779-9800
(713) 779-9813
Mailing address
7324 SW FREEWAY, SUITE 1550, HOUSTON, TX 77074-2053
(713) 779-9800
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
3933
KS
246ZS0410X
Surgical Technologist
3933
KS
Other
Enumeration date
09/11/2012
Last updated
02/18/2014
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