Healthcare Provider Details

I. General information

NPI: 1184040768
Provider Name (Legal Business Name): MRS. CELINA GONZALES SISK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2014
Last Update Date: 03/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15914 ARAPAHO BEND LN ARAPAHO BEND LANE
CYPRESS TX
77429-5959
US

IV. Provider business mailing address

15914 ARAPAHO BEND LN ARAPAHO BEND LANE
CYPRESS TX
77429-5959
US

V. Phone/Fax

Practice location:
  • Phone: 832-367-5282
  • Fax:
Mailing address:
  • Phone: 832-367-5282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: