Individual
JAVON DEONTAY SCOTT-FLETCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16307 MANGO RIDGE CT, HUMBLE, TX 77396-3961
(713) 614-1675
Mailing address
16307 MANGO RIDGE CT, HUMBLE, TX 77396-3961
(713) 614-1675
Taxonomy
Speciality
Code
Description
License number
State
332BD1200X
Dialysis Equipment & Supplies (DME)
Primary
1712206
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41701256
MEDICAL UNITS
TX
Enumeration date
07/08/2021
Last updated
07/08/2021
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