Individual
DEVONDA CHANTAL WYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16800 IMPERIAL VALLEY DR STE 280, HOUSTON, TX 77060-3161
(832) 910-7304
(832) 565-1193
Mailing address
16800 IMPERIAL VALLEY DR STE 280, HOUSTON, TX 77060-3161
(832) 910-7304
(832) 565-1193
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
CPT19-7289
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000
COMERCIAL INSURANCE
TX
Enumeration date
12/11/2019
Last updated
12/11/2019
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