Healthcare Provider Details

I. General information

NPI: 1760763551
Provider Name (Legal Business Name): MRS. IRIS YVONNE MCKELVEY-CHEVALIER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2011
Last Update Date: 09/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4633 PARDEE ST
HOUSTON TX
77026-2835
US

IV. Provider business mailing address

4633 PARDEE ST
HOUSTON TX
77026-2835
US

V. Phone/Fax

Practice location:
  • Phone: 713-674-6235
  • Fax: 713-674-6235
Mailing address:
  • Phone: 713-674-6235
  • Fax: 713-674-6235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number171WH0202X
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: