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Organization

CROWN LUX WIGS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GENEVIEVE DICKERSON (OWNER)
(713) 377-8087
Entity
Organization

Contact information

Practice address
16630 IMPERIAL VALLEY DR, HOUSTON, TX 77060-3409
(713) 377-8087
(713) 583-1671
Mailing address
16630 IMPERIAL VALLEY DR, HOUSTON, TX 77060-3409
(713) 377-8087
(713) 583-1671

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Enumeration date
08/14/2020
Last updated
08/14/2020
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