Provider Demographics
NPI:1679803142
Name:SANDRA M HUETE LLC
Entity type:Organization
Organization Name:SANDRA M HUETE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUETE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-668-2225
Mailing Address - Street 1:4026 GLENSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-3908
Mailing Address - Country:US
Mailing Address - Phone:713-668-2225
Mailing Address - Fax:713-668-3616
Practice Address - Street 1:8305 KNIGHT RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-3905
Practice Address - Country:US
Practice Address - Phone:713-668-2225
Practice Address - Fax:713-668-3616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-06
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2509111N00000X, 111NN0400X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty