Individual
ALICIA LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3332 PLAINVIEW ST, PASADENA, TX 77504-1906
(832) 649-2073
Mailing address
406 HALKIES ST, SOUTH HOUSTON, TX 77587-3725
(281) 851-7203
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
134881
TX
Other
Enumeration date
12/21/2017
Last updated
12/21/2017
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