Provider Demographics
NPI:1801051644
Name:KING, HENRIETTA (RN)
Entity type:Individual
Prefix:MS
First Name:HENRIETTA
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9314 SUMMERBELL LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1343
Mailing Address - Country:US
Mailing Address - Phone:713-995-9059
Mailing Address - Fax:713-995-5050
Practice Address - Street 1:9314 SUMMERBELL LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1343
Practice Address - Country:US
Practice Address - Phone:713-995-9059
Practice Address - Fax:713-995-5050
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX552575171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator