Provider Demographics
NPI:1295780294
Name:LUCIANA L READO
Entity type:Organization
Organization Name:LUCIANA L READO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LUCIANA
Authorized Official - Middle Name:LENNETTE
Authorized Official - Last Name:READO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-583-1810
Mailing Address - Street 1:14450 T C JESTER BLVD
Mailing Address - Street 2:STE 105
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014-1386
Mailing Address - Country:US
Mailing Address - Phone:281-583-1810
Mailing Address - Fax:713-583-9150
Practice Address - Street 1:14450 T C JESTER BLVD
Practice Address - Street 2:STE 105
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-1386
Practice Address - Country:US
Practice Address - Phone:281-583-1810
Practice Address - Fax:713-583-9150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0088618332BX2000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5724210001Medicare NSC