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General NPI Number Information
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NPI Number | 1609647585
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Entity Type | Organization
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Legal Business Name | CHILDREN EMPOWERMENT AND DEVELOPMENT SERVICES, LLC
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Dates
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Enumeration Date | 01/10/2024
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Last Update Date | 01/10/2024
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Provider Practice Location Address
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Address Line | 1110 TEXAS PARKWAY STAFFORD, TEXAS 77477 SUITE 600
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City | STAFFORD
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State | TX
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Zip | 77477
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Country | US
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Telephone | 281-940-6686
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Fax |
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Provider Business Mailing Address
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Address Line | 1110 TEXAS PARKWAY STAFFORD, TEXAS 77477 SUITE 600
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City | STAFFORD
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State | TX
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Zip | 77477
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Country | US
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Telephone | 281-940-6686
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | KATINA LEWIS
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Credential | LVN
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Telephone | 281-940-6686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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