Organization
REDICLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICA MALEIGH WYNN VELA NP-C (FAMILY NURSE PRACTITIONER)
(832) 632-2170
Entity
Organization
Contact information
Practice address
701 W PARKWOOD AVE, FRIENDSWOOD, TX 77546-5405
(281) 947-0018
Mailing address
2801 VENETO CT, LEAGUE CITY, TX 77573-5006
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
717330
TX
Other
Enumeration date
10/23/2012
Last updated
05/13/2014
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