Healthcare Provider Details

I. General information

NPI: 1255844841
Provider Name (Legal Business Name): TLC PULMONARY FUNCTION TESTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2017
Last Update Date: 11/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8303 SOUTWEST FREEWAY SUITE 550
HOUSTON TX
77074-1698
US

IV. Provider business mailing address

8303 SOUTWEST FREEWAY SUITE 550
HOUSTON TX
77074-1698
US

V. Phone/Fax

Practice location:
  • Phone: 832-451-8958
  • Fax: 346-223-0223
Mailing address:
  • Phone: 832-451-8958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279P1004X
TaxonomyPulmonary Diagnostics Registered Respiratory Therapist
License Number00062719
License Number StateTX

VIII. Authorized Official

Name: FALESHIA COLEMAN
Title or Position: OWNER
Credential: RRT
Phone: 832-606-7151