Provider Demographics
NPI:1396316683
Name:HADDAD, LATONYA L (NP)
Entity type:Individual
Prefix:
First Name:LATONYA
Middle Name:L
Last Name:HADDAD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:525 N SAM HOUSTON PKWY E STE 255
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-4017
Mailing Address - Country:US
Mailing Address - Phone:832-672-4739
Mailing Address - Fax:832-575-4999
Practice Address - Street 1:6000 W RAYFORD RD APT 3201
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77389-2211
Practice Address - Country:US
Practice Address - Phone:832-741-2474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1011779208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics