Provider Demographics
NPI:1184046070
Name:SAULETTE QUEEN, MD, PLLC
Entity Type:Organization
Organization Name:SAULETTE QUEEN, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SAULETTE
Authorized Official - Middle Name:RAQUEL
Authorized Official - Last Name:QUEEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-376-0814
Mailing Address - Street 1:100 MEDICAL CENTER BLVD
Mailing Address - Street 2:STE. 200
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2888
Mailing Address - Country:US
Mailing Address - Phone:713-376-0814
Mailing Address - Fax:
Practice Address - Street 1:100 MEDICAL CENTER BLVD
Practice Address - Street 2:STE. 200
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2888
Practice Address - Country:US
Practice Address - Phone:713-376-0814
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-10
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6361207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty