Individual
MS. FERELY DEL VALLE CORREA MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1759 LAKESIDE ENCLAVE DR, HOUSTON, TX 77077-1690
(713) 391-9484
Mailing address
1759 LAKESIDE ENCLAVE DR, HOUSTON, TX 77077-1690
(713) 391-9484
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34695801
DRIVER LICENSE
TX
Enumeration date
10/27/2021
Last updated
10/27/2021
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