Healthcare Provider Details

I. General information

NPI: 1659452126
Provider Name (Legal Business Name): EVELLAR MERRITT RESPIRATORY THERAPY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2946 CARRIZO SPRINGS, CT
KATY TX
77449
US

IV. Provider business mailing address

2946 CARRIZO SPRINGS CT
KATY TX
77449
US

V. Phone/Fax

Practice location:
  • Phone: 281-398-4985
  • Fax:
Mailing address:
  • Phone: 281-398-4985
  • Fax: 281-398-0667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2278G1100X
TaxonomyGeneral Care Certified Respiratory Therapist
License Number60935
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: