Quincy Vincent Lodge CRNA

NPI 1093999021 - Registered Nurse - 163WC0200X

NPI Details
NPI 1093999021
Gender Male
Enumeration Date 12/27/2007
Last Updated 01/22/2015
Entity Type Individual
Active Over 8 years ago
Practice Location
2411 FOUNTAIN VIEW DR
STE. 200
HOUSTON TX, 77057-4817, US
Phone (713) 620-4000
Fax
Business Location
2411 FOUNTAIN VIEW DR
STE. 200
HOUSTON TX, 77057-4817, US
Phone (713) 620-4000
Fax
Toxanomy
Taxonomy Code 163WC0200X
License State New Jersey
License Number 26NR12004300
Remove 1093999021 NPI Number
 

According to our database, Quincy Vincent Lodge CRNA NPI is 1093999021, taxonomy code is 163WC0200X and license number is 26NR12004300, license state is located at New Jersey. Quincy Vincent Lodge CRNA physically located at 2411 Fountain View Dr, Houston TX, 77057-4817. NPI Number Quincy Vincent Lodge CRNA has the Individual type.

Sponsored links

1093999021 NPI number is provided on an as is basis without warranty of any kind. 1093999021 is maintained by the National Plan & Provider Enumeration System. The contents of Quincy Vincent Lodge CRNA are for informational purposes only.