Organization
HEAVENLYNAILS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VICKI ROCHELLE MARTIN LICENSED (WOUND AND SKIN CARE)
(214) 641-6338
Entity
Organization
Contact information
Practice address
1406 CYPRESS STATION DR, # 1406, HOUSTON, TX 77090
(214) 641-6338
Mailing address
601 CYPRESS STATION DR, # 1406, HOUSTON, TX 77090-1507
(214) 641-6338
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
311ZA0620X
Adult Care Home Facility
Primary
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
Other
Enumeration date
07/12/2013
Last updated
07/12/2013
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