Healthcare Provider Details

I. General information

NPI: 1376035378
Provider Name (Legal Business Name): HDPS SERIES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2018
Last Update Date: 06/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 S MASON RD
KATY TX
77450-7633
US

IV. Provider business mailing address

16926 SOUTHWEST FWY
SUGAR LAND TX
77479-2350
US

V. Phone/Fax

Practice location:
  • Phone: 281-665-2626
  • Fax:
Mailing address:
  • Phone: 281-313-0555
  • Fax: 281-313-0554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ERIC HUMBLE
Title or Position: PRESIDENT
Credential: MD
Phone: 281-313-0555