Provider Demographics
NPI:1710743794
Name:VERNON ENTERPRISE, LLC
Entity Type:Organization
Organization Name:VERNON ENTERPRISE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:OLANA TAYLOR
Authorized Official - Last Name:VERNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-549-3948
Mailing Address - Street 1:8190 BARKER CYPRESS RD STE 1900-512
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-1223
Mailing Address - Country:US
Mailing Address - Phone:832-533-2473
Mailing Address - Fax:832-533-8348
Practice Address - Street 1:2300 GREEN OAK DR STE 150
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2038
Practice Address - Country:US
Practice Address - Phone:832-533-2473
Practice Address - Fax:832-533-8348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy