Healthcare Provider Details

I. General information

NPI: 1861225435
Provider Name (Legal Business Name): MRS. ERICA NICOLE SYKES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2024
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 KINGWOOD DR STE 200-240
KINGWOOD TX
77339-3060
US

IV. Provider business mailing address

PO BOX 632
NEW CANEY TX
77357-0632
US

V. Phone/Fax

Practice location:
  • Phone: 832-233-3086
  • Fax:
Mailing address:
  • Phone: 936-537-7210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number89555
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: