Healthcare Provider Details

I. General information

NPI: 1366942260
Provider Name (Legal Business Name): ANNA HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2018
Last Update Date: 02/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16939 JONQUIL PATH WAY
CONROE TX
77385-5065
US

IV. Provider business mailing address

3315 MARQUART ST STE 209
HOUSTON TX
77027-6027
US

V. Phone/Fax

Practice location:
  • Phone: 936-446-9738
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number902005
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: