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General NPI Number Information
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NPI Number | 1912408923
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Entity Type | Individual
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Provider Name | DALLAS R KING LVN
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Gender | Female
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Dates
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Enumeration Date | 02/24/2018
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 18011 SECO CREEK LN
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City | HUMBLE
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State | TX
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Zip | 77396-4681
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Country | US
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Telephone | 281-515-5824
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Fax | 281-838-8009
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Provider Business Mailing Address
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Address Line | 7510 DECKER DR APT 1308
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City | BAYTOWN
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State | TX
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Zip | 77520-1069
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Country | US
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Telephone | 281-515-5824
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Fax | 281-838-8009
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | 224864
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License Number State | TX
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