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General NPI Number Information
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NPI Number | 1265974497
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Entity Type | Organization
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Legal Business Name | ZANDERSON BUSINESS GROUP
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Dates
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Enumeration Date | 11/04/2016
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Last Update Date | 11/04/2016
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Provider Practice Location Address
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Address Line | 6942 FM 1960 RD E # 180
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City | HUMBLE
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State | TX
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Zip | 77346-2706
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Country | US
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Telephone | 832-725-2254
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Fax |
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Provider Business Mailing Address
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Address Line | 6942 FM 1960 RD E # 180
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City | HUMBLE
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State | TX
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Zip | 77346-2706
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Country | US
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Telephone | 832-725-2254
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LASTACIE D JOHNSON
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Credential |
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Telephone | 832-725-2254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 251K00000X
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License Number State | TX
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