MEDICARE: BAYOU CITY BREASTFEEDING, LLC

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
1	174N00000X	Lactation Consultant (Non-RN)
2	163WL0100X	Lactation Consultant (Registered Nurse)

General Provider Information

NPI Number	:	1376056085
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAYOU CITY BREASTFEEDING, LLC

Provider Business Mailing Address
First Line	:	3007 WOODLAND HILLS DR # 205
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77339-1403
Country	:	US
Telephone Number	:	281-626-5271
Fax Number	:	281-572-0627

Provider Business Practice Location Address
First Line	:	3100 RICHMOND AVE STE 302
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-3015
Country	:	US
Telephone Number	:	281-305-0411
Fax Number	:	844-440-2819

Authorized Official
Title or Position	:	MANAGING DIRECTOR
Name	:	SUZANNE HARRIS JUEL
Credential	:	IBCLC
Telephone Number	:	281-305-0411

Provider Enumeration Date	:	11/16/2017
Last Update Date	:	03/26/2024

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Directions to “BAYOU CITY BREASTFEEDING, LLC ” Practice Location

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