Provider Demographics
NPI:1356351324
Name:SWEET, THERESA L (CSFA)
Entity type:Individual
Prefix:MS
First Name:THERESA
Middle Name:L
Last Name:SWEET
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2414 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-1432
Mailing Address - Country:US
Mailing Address - Phone:713-521-2414
Mailing Address - Fax:832-413-5404
Practice Address - Street 1:2414 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-1432
Practice Address - Country:US
Practice Address - Phone:713-521-2414
Practice Address - Fax:832-413-5404
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122709246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant