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General NPI Number Information
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NPI Number | 1821532599
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Entity Type | Organization
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Legal Business Name | SUPREME ALL CARE HEALTH AND WELLNESS
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Dates
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Enumeration Date | 12/14/2016
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Last Update Date | 12/14/2016
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Provider Practice Location Address
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Address Line | 530 N SAM HOUSTON PKWY E 110
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City | HOUSTON
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State | TX
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Zip | 77060-4038
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Country | US
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Telephone | 281-416-4664
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Fax | 281-416-4719
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Provider Business Mailing Address
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Address Line | 7127 YELLOW PINE DR
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City | HOUSTON
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State | TX
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Zip | 77040-1846
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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 | TIRTONIA HOWARD
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Credential |
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Telephone | 832-453-3839
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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