Provider Demographics
NPI:1356111348
Name:DANIELS, EBONY (CNA, EKG TECHNICIAN)
Entity type:Individual
Prefix:
First Name:EBONY
Middle Name:
Last Name:DANIELS
Suffix:
Gender:F
Credentials:CNA, EKG TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15380 KUYKENDAHL RD STE 244
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-4104
Mailing Address - Country:US
Mailing Address - Phone:832-835-0605
Mailing Address - Fax:
Practice Address - Street 1:15330 ELLA BLVD APT 103
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-5321
Practice Address - Country:US
Practice Address - Phone:318-759-9460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other