Organization
MY INFANT NEEDS,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY FAYE SELF RN,BSN (DIRECTOR)
(903) 563-4765
Entity
Organization
Contact information
Practice address
407 COUNTY ROAD 1520, MT PLEASANT, TX 75455-7378
(903) 563-4765
Mailing address
407 COUNTY ROAD 1520, MT PLEASANT, TX 75455-7378
(903) 563-4765
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
11291501
TX
163WM0102X
Maternal Newborn Registered Nurse
716125
TX
332B00000X
Durable Medical Equipment & Medical Supplies
—
TX
Other
Enumeration date
12/15/2010
Last updated
11/06/2012
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