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General NPI Number Information
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NPI Number | 1699199166
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Entity Type | Organization
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Legal Business Name | KATY NEURO & WELLNESS CENTER PLLC
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Dates
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Enumeration Date | 02/04/2014
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Last Update Date | 03/18/2014
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Provider Practice Location Address
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Address Line | 4600 HIGHWAY 6 N SUITE 207
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City | HOUSTON
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State | TX
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Zip | 77084-2884
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Country | US
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Telephone | 281-345-7547
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Fax |
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Provider Business Mailing Address
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Address Line | 4600 HIGHWAY 6 N SUITE 207
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City | HOUSTON
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State | TX
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Zip | 77084-2884
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARY LOU ALONSO
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Credential | NP
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Telephone | 281-345-7547
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 721070
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License Number State | TX
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