Individual
MARLA RENEE WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
12371 S KIRKWOOD RD, STAFFORD, TX 77477-2836
(713) 995-9292
Mailing address
21126 ALLENHAM LN, HUMBLE, TX 77338-3000
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
348133
TX
Other
Enumeration date
07/15/2019
Last updated
07/15/2019
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