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General NPI Number Information
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NPI Number | 1184046070
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Entity Type | Organization
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Legal Business Name | SAULETTE QUEEN, MD, PLLC
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Dates
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Enumeration Date | 01/10/2014
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Last Update Date | 10/01/2014
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Provider Practice Location Address
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Address Line | 100 MEDICAL CENTER BLVD STE. 200
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City | CONROE
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State | TX
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Zip | 77304-2888
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Country | US
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Telephone | 713-376-0814
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Fax |
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Provider Business Mailing Address
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Address Line | 100 MEDICAL CENTER BLVD STE. 200
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City | CONROE
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State | TX
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Zip | 77304-2888
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Country | US
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Telephone | 713-376-0814
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Fax |
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Authorized Official
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Title or Position | CARDIOLOGIST
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Name | DR. SAULETTE RAQUEL QUEEN
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Credential | M.D.
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Telephone | 713-376-0814
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | M6361
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License Number State | TX
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