Provider Demographics
NPI:1326568007
Name:STRAIGHT TO YOU HEALTHCARE PLLC
Entity Type:Organization
Organization Name:STRAIGHT TO YOU HEALTHCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:DICKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:AGNP-C
Authorized Official - Phone:832-559-2273
Mailing Address - Street 1:24230 KUYKENDAHL RD STE 210-216
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-5123
Mailing Address - Country:US
Mailing Address - Phone:832-559-2273
Mailing Address - Fax:
Practice Address - Street 1:25351 BARMBY DR
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-5639
Practice Address - Country:US
Practice Address - Phone:832-559-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-22
Last Update Date:2017-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128553261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center