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General NPI Number Information
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NPI Number | 1851763171
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Entity Type | Organization
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Legal Business Name | DYNAMIC MEDICAL MANAGEMENT, INC.
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Dates
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Enumeration Date | 10/26/2015
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 3050 POST OAK BLVD STE 510
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City | HOUSTON
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State | TX
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Zip | 77056-6512
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Country | US
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Telephone | 281-339-9535
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Fax | 281-339-9536
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Provider Business Mailing Address
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Address Line | 565 S MASON RD # 437
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City | KATY
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State | TX
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Zip | 77450-2437
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Country | US
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Telephone | 214-641-8610
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Fax | 281-339-9536
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Authorized Official
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Title or Position | NURSE PRACTITIONER/PRESIDENT
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Name | VERONICA WEATHERSPOON
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Credential | APRN, FNP-C
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Telephone | 214-641-8610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP124919
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License Number State | TX
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