Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 729303 | TX |
NPI | 1003233602 |
---|---|
Provider Name | Sandra Lee Kloeber |
First Address | Sugar Land, TX 77479-6338 |
Second Address | Sugar Land, TX 77479 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2014 |
Last Update Date | 21/03/2014 |