Organization
ST MARYS MEDI SPA LLC
Active
Other names
St Marys Medi Spa
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE WATSON NURSE PRACTITIONER (PROVIDER)
(713) 524-2633
Entity
Organization
Contact information
Practice address
4102 FANNIN ST, HOUSTON, TX 77004-4808
(713) 524-2633
(713) 524-2639
Mailing address
4102 FANNIN ST, HOUSTON, TX 77004-4808
(713) 524-2633
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
06/28/2021
Last updated
06/28/2021
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