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General NPI Number Information
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NPI Number | 1205708716
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Entity Type | Organization
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Legal Business Name | LAVENDER COLLECTIVE
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 460 JONES AVE UNIT A
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City | BLANCO
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State | TX
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Zip | 78606-5424
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Country | US
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Telephone | 830-392-6342
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Fax |
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Provider Business Mailing Address
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Address Line | 460 JONES AVE UNIT A
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City | BLANCO
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State | TX
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Zip | 78606-5424
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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 | CLINIC DIRECTOR
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Name | DR. CORI PICAZO
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Credential | DC
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Telephone | 713-594-2398
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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