Individual
MS. KIMIJUAN ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
SERENITYDIABETICMEDICAL@GMAIL.COM, 14230 WUNDERLICH DRIVE APT 264, HOUSTON, TX 77069
(504) 952-0797
Mailing address
SERENITYDIABETICMEDICAL@GMAIL.COM, 14230 WUNDERLICH DRIVE APT 264, HOUSTON, TX 77069
(504) 952-0797
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86-3861086
MEDICAL SUPPLIES
TX
Enumeration date
07/12/2022
Last updated
07/12/2022
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