Provider Demographics
NPI:1659947000
Name:WAVEONWAVE, LLC
Entity Type:Organization
Organization Name:WAVEONWAVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-825-8608
Mailing Address - Street 1:7102 W SAM HOUSTON PKWY N STE 225
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-3165
Mailing Address - Country:US
Mailing Address - Phone:713-426-1669
Mailing Address - Fax:713-868-9416
Practice Address - Street 1:7102 W SAM HOUSTON PKWY N STE 225
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040-3165
Practice Address - Country:US
Practice Address - Phone:713-426-1669
Practice Address - Fax:713-868-9416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
No367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist AssistantGroup - Single Specialty