Organization
RAINBOWS AND MOONBEAMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROGER A WIES (PRESIDENT)
(254) 412-0382
Entity
Organization
Contact information
Practice address
19206 JUERGEN RD, TOMBALL, TX 77377-5758
(281) 255-4327
Mailing address
19206 JUERGEN RD, TOMBALL, TX 77377-5758
(281) 255-4327
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
—
Other
Enumeration date
09/06/2007
Last updated
09/06/2007
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