Individual
QUEEN TANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12520 WESTHEIMER RD A-1 #201, 2307, HOUSTON, TX 77077-5567
(832) 786-9518
Mailing address
234 MEYER ST, SEALY, TX 77474-2325
(832) 786-9518
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
06/01/2011
Last updated
04/28/2014
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