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General NPI Number Information
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NPI Number | 1740358191
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Entity Type | Organization
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Legal Business Name | SECOND SILHOUETTE, INC
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Dates
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Enumeration Date | 12/02/2006
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Last Update Date | 11/01/2007
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Provider Practice Location Address
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Address Line | 17000 EL CAMINO REAL SUITE 106
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City | HOUSTON
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State | TX
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Zip | 77058-2636
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Country | US
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Telephone | 281-286-1943
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Fax | 281-286-4340
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Provider Business Mailing Address
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Address Line | 17000 EL CAMINO REAL SUITE 106
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City | HOUSTON
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State | TX
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Zip | 77058-2636
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Country | US
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Telephone | 281-286-1943
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Fax | 281-286-4340
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | PAMELA J PETAK
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Credential |
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Telephone | 713-529-3733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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