Healthcare Provider Details

I. General information

NPI: 1508565938
Provider Name (Legal Business Name): MS. TERRI RENEE PALMER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2023
Last Update Date: 02/24/2023
Certification Date: 02/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18075 W LITTLE YORK RD STE G
KATY TX
77449-7241
US

IV. Provider business mailing address

18075 W LITTLE YORK RD STE G
KATY TX
77449-7241
US

V. Phone/Fax

Practice location:
  • Phone: 832-683-4809
  • Fax: 832-683-4569
Mailing address:
  • Phone: 832-683-4809
  • Fax: 832-683-4569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: