Healthcare Provider Details

I. General information

NPI: 1043809312
Provider Name (Legal Business Name): KAREN SUE TEUTSCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2021
Last Update Date: 01/12/2021
Certification Date: 01/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14100 SPRING CYPRESS RD
CYPRESS TX
77429-6286
US

IV. Provider business mailing address

14100 SPRING CYPRESS RD
CYPRESS TX
77429-6286
US

V. Phone/Fax

Practice location:
  • Phone: 281-376-2428
  • Fax: 281-320-3783
Mailing address:
  • Phone: 281-376-2428
  • Fax: 281-320-3783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: