Healthcare Provider Details

I. General information

NPI: 1013606912
Provider Name (Legal Business Name): NOIR ETERPRISE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2023
Last Update Date: 05/05/2023
Certification Date: 05/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10242 GREENHOUSE RD STE 401
CYPRESS TX
77433-1827
US

IV. Provider business mailing address

29122 AUTUMN BROOK DR
FULSHEAR TX
77441-1929
US

V. Phone/Fax

Practice location:
  • Phone: 713-540-2694
  • Fax:
Mailing address:
  • Phone: 713-540-2694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: EDWARD WASHINGTON
Title or Position: PARTNER
Credential:
Phone: 713-540-2694