Individual
INNOCENT KEN IKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
63 RIVERCOACH LN, SUGAR LAND, TX 77479-5545
(832) 359-7755
(281) 565-5705
Mailing address
63 RIVERCOACH LN, SUGAR LAND, TX 77479-5545
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/30/2011
Last updated
12/19/2013
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