Provider Demographics
NPI:1912622143
Name:MOBILE DESIGNER DRIPS LLC
Entity Type:Organization
Organization Name:MOBILE DESIGNER DRIPS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSEKA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:936-900-2154
Mailing Address - Street 1:2119 BROADLAWN DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2240
Mailing Address - Country:US
Mailing Address - Phone:936-900-2154
Mailing Address - Fax:
Practice Address - Street 1:5211 E WALLISVILLE RD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-8742
Practice Address - Country:US
Practice Address - Phone:713-422-3178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion TherapyGroup - Single Specialty