Individual
MAKEDA FORDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
8700 CROWNHILL BLVD STE 300, SAN ANTONIO, TX 78209-1128
(210) 824-5530
Mailing address
9211 BROADWAY ST UNIT 17162, SAN ANTONIO, TX 78217-7007
(210) 204-6493
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
348044
TX
Other
Enumeration date
04/07/2019
Last updated
04/07/2019
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