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General NPI Number Information
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NPI Number | 1497703946
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Entity Type | Organization
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Legal Business Name | KAREN BROUSSARD
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 03/14/2008
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Provider Practice Location Address
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Address Line | 10645 RICHMOND AVE SUITE 160
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City | HOUSTON
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State | TX
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Zip | 77042-4923
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Country | US
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Telephone | 713-974-1176
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Fax | 713-783-2679
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Provider Business Mailing Address
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Address Line | 10645 RICHMOND AVE SUITE 160
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City | HOUSTON
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State | TX
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Zip | 77042-4923
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Country | US
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Telephone | 713-974-1176
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Fax | 713-783-2679
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DEANNA ESTES
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Credential |
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Telephone | 713-974-1176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0080639
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License Number State | TX
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