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General NPI Number Information
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NPI Number | 1306605803
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Entity Type | Individual
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Provider Name | MONIQUE PERRY LVN
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Gender | Female
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Dates
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Enumeration Date | 03/18/2024
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 5455 RICHMOND AVE APT 4054
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City | HOUSTON
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State | TX
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Zip | 77056-7057
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Country | US
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Telephone | 832-574-0880
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Fax |
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Provider Business Mailing Address
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Address Line | 5900 BALCONES DR # 24197
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City | AUSTIN
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State | TX
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Zip | 78731-4257
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Country | US
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Telephone | 281-503-8587
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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 | 225000000X
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Taxonomy Name | Orthotic Fitter
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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