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NPI Code Detail

MEDICARE: LOUELA DANDY

MEDICARE: LOUELA DANDY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker55977TX

General Provider Information

NPI Number : 1164122412
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOUELA DANDY
Provider Business Mailing Address
First Line : 19707 N VILLAGE OF BRIDGESTONE LN
Second Line :
City : SPRING
State : TX
Zip : 77379-6497
Country : US
Telephone Number : 832-334-2490
Fax Number :
Provider Business Practice Location Address
First Line : 701 N POST OAK RD STE 145
Second Line :
City : HOUSTON
State : TX
Zip : 77024-3923
Country : US
Telephone Number : 713-364-6275
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2023
Last Update Date : 03/06/2023

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Directions to “ LOUELA DANDY ” Practice Location

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