Provider Demographics
NPI:1225732233
Name:KENT, LATOYA L
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:L
Last Name:KENT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5704 VAL VERDE ST STE 3
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-5726
Mailing Address - Country:US
Mailing Address - Phone:978-822-0781
Mailing Address - Fax:
Practice Address - Street 1:5704 VAL VERDE ST STE 3
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-5726
Practice Address - Country:US
Practice Address - Phone:978-822-0781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE1399332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies