Healthcare Provider Details

I. General information

NPI: 1891559837
Provider Name (Legal Business Name): KYNDALL BROOKE ERRICSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2024
Last Update Date: 02/09/2024
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9230 KATY FWY STE 420
HOUSTON TX
77055-7468
US

IV. Provider business mailing address

12310 WESTWOLD DR
TOMBALL TX
77377-8045
US

V. Phone/Fax

Practice location:
  • Phone: 580-585-2800
  • Fax:
Mailing address:
  • Phone: 580-585-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: