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General NPI Number Information
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NPI Number | 1093469256
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Entity Type | Organization
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Legal Business Name | QUEEN AESTHETICS
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Dates
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Enumeration Date | 02/07/2022
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Last Update Date | 02/07/2022
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Provider Practice Location Address
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Address Line | 333 WEST LOOP N STE 440
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City | HOUSTON
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State | TX
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Zip | 77024-5313
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Country | US
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Telephone | 832-426-4489
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Fax |
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Provider Business Mailing Address
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Address Line | 333 WEST LOOP N STE 440
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City | HOUSTON
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State | TX
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Zip | 77024-5313
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SIMONE HOPES
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Credential |
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Telephone | 832-715-7547
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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