Individual
CRYSTAL DENISE ROQUEMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4142 PHLOX ST, HOUSTON, TX 77051
(832) 816-7074
Mailing address
4142 PHLOX ST, HOUSTON, TX 77051
(832) 816-7074
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1920
VA
TX
Enumeration date
07/18/2022
Last updated
07/18/2022
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