Healthcare Provider Details
I. General information
NPI: 1063849453
Provider Name (Legal Business Name): NLA ENTERPRISES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/01/2013
Last Update Date: 10/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4200 TWELVE OAKS DR
HOUSTON TX
77027-6812
US
IV. Provider business mailing address
5120 WOODWAY DR SUITE 7012
HOUSTON TX
77056-1723
US
V. Phone/Fax
- Phone: 713-532-7311
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DIEU RICK
NGO
Title or Position: MANAGING MEMBER
Credential:
Phone: 713-532-7311