Provider Information for 1063638377
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SHONDREKA AMOS
Sex: Female
NPI: 1063638377
Last Updated: 2024-10-01
Certification Date: 2024-10-01
Certification Date: 2024-10-01
Details
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NPI | 1063638377 | ||||||||
Enumeration Date | 2007-04-17 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
Mailing Address | 1322 SPACE PARK DR STE B143 HOUSTON, TX 77058-3539 United States Phone: 214-702-6613 | Fax: | ||||||||
Primary Practice Address | 1322 SPACE PARK DR # BI43 HOUSTON, TX 77058-3400 United States Phone: 214-702-6613 | Fax: | ||||||||
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