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General NPI Number Information
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NPI Number | 1417357955
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Entity Type | Organization
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Legal Business Name | DST MANAGEMENT LLC
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Dates
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Enumeration Date | 09/03/2014
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Last Update Date | 09/03/2014
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Provider Practice Location Address
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Address Line | 19627 INTERSTATE 45 STE 425
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City | SPRING
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State | TX
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Zip | 77388-6030
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Country | US
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Telephone | 281-319-4910
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Fax | 832-663-9371
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Provider Business Mailing Address
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Address Line | 19627 INTERSTATE 45 STE 425
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City | SPRING
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State | TX
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Zip | 77388-6030
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Country | US
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Telephone | 281-319-4910
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Fax | 832-663-9371
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Authorized Official
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Title or Position | CEO
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Name | KIM HENRY
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Credential |
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Telephone | 281-319-4910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246Z00000X
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Taxonomy Name | Other Specialist/Technologist
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License Number |
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License Number State |
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