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General NPI Number Information
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NPI Number | 1033727656
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Entity Type | Individual
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Provider Name | JANAYE RACHELLE WHITE WIG SPECIALIST
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Gender | Female
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Dates
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Enumeration Date | 07/20/2020
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Last Update Date | 07/20/2020
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Provider Practice Location Address
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Address Line | 8413 ALMEDA RD STE Q2
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City | HOUSTON
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State | TX
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Zip | 77054-7103
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Country | US
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Telephone | 281-772-2665
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Fax |
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Provider Business Mailing Address
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Address Line | 11070 KATY FWY APT 1271
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City | HOUSTON
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State | TX
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Zip | 77043-4765
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Country | US
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Telephone | 281-772-2665
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1744P3200X
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Taxonomy Name | Prosthetics Case Management
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License Number | 1837282
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number | 1837282
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License Number State | TX
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