Individual
CONSTANCE GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
801 W FAIRMONT PKWY, LA PORTE, TX 77572-1329
(832) 677-2248
Mailing address
PO BOX 227, LA PORTE, TX 77572-0227
(832) 677-2248
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
—
TX
347C00000X
Private Vehicle
Primary
—
TX
Other
Enumeration date
08/05/2015
Last updated
08/05/2015
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