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NPI Code Detail

MEDICARE: REENA STHROHLINE CPED

MEDICARE: REENA STHROHLINE CPED
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224L00000XPedorthist

General Provider Information

NPI Number : 1063770113
Entity Type Code : Individual
Provider Name (Legal Business Name) : REENA STHROHLINE CPED
Provider Business Mailing Address
First Line : 11155 MAIN ST
Second Line :
City : HOUSTON
State : TX
Zip : 77025-5600
Country : US
Telephone Number : 713-474-4171
Fax Number : 713-747-4249
Provider Business Practice Location Address
First Line : 11155 MAIN ST
Second Line :
City : HOUSTON
State : TX
Zip : 77025-5600
Country : US
Telephone Number : 713-474-4171
Fax Number : 713-747-4249
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2012
Last Update Date : 04/26/2012

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Directions to “ REENA STHROHLINE CPED” Practice Location

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