Provider Demographics
NPI:1356641823
Name:BOSTON, QUINETTA
Entity Type:Individual
Prefix:MRS
First Name:QUINETTA
Middle Name:
Last Name:BOSTON
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 1:5326 SPANISH OAK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77066-2821
Mailing Address - Country:US
Mailing Address - Phone:832-367-3669
Mailing Address - Fax:281-764-9557
Practice Address - Street 1:5326 SPANISH OAK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77066-2821
Practice Address - Country:US
Practice Address - Phone:832-367-3669
Practice Address - Fax:281-764-9557
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver