Provider Demographics
NPI:1669724662
Name:SPEED, SANDRA RIO (RNFA)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:RIO
Last Name:SPEED
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:MRS
Other - First Name:SANDIE
Other - Middle Name:RIO
Other - Last Name:SPEED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RNFA
Mailing Address - Street 1:10565 KATY FREEWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024
Mailing Address - Country:US
Mailing Address - Phone:713-467-0146
Mailing Address - Fax:
Practice Address - Street 1:10565 KATY FWY
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1007
Practice Address - Country:US
Practice Address - Phone:713-467-0146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX241861163WS0121X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0121XNursing Service ProvidersRegistered NursePlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX241861OtherRNFA