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Individual

ECO AZURED WADE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PROVIDER

Contact information

Practice address
18727 HOLLY WAY, HOUSTON, TX 77084-3880
(281) 235-6348
Mailing address
18691 CLAY RD, HOUSTON, TX 77084-7241
(281) 235-6348

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary

Other

Enumeration date
06/15/2020
Last updated
06/15/2020
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