Healthcare Provider Details

I. General information

NPI: 1699584516
Provider Name (Legal Business Name): ANGELA MOTTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 CYPRESS CREEK PKWY STE 322
HOUSTON TX
77068-3547
US

IV. Provider business mailing address

3920 CYPRESS CREEK PKWY STE 322
HOUSTON TX
77068-3547
US

V. Phone/Fax

Practice location:
  • Phone: 832-620-3229
  • Fax: 832-201-6933
Mailing address:
  • Phone: 832-620-3229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: