LYDIA DANIELLE BREEDLOVE (NPI# 1194242545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194242545 |
| Entity Type | Individual |
| Full Name | LYDIA DANIELLE BREEDLOVE |
| Practice Address |
12310 Rincon Drive Houston TX 77077 |
| Mailing Address |
12310 Rincon Dr Houston TX 77077-4828 |
| Practice Telephone | (832) 377-9378 |
| Mailing Telephone | 8323779378 |
| Enumeration Date | 2017-08-26 |
| Last Update Date | 2017-08-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
36442954 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | 36442954 | TX | Student, Health Care |
| Street Address |
12310 RINCON DRIVE |
| City | HOUSTON |
| State | TX |
| Zip Code | 77077 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407457922 | Tam Minh Ha | Pharmacist | 2700 S Kirkwood, Houston, TX 77077 | 2020-11-02 |
| 1497396881 | Laboratory Concepts | Technician, Pathology | 2025 Gentryside Dr, Houston, TX 77077 | 2019-10-07 |
| 1447730940 | Olufunke O'banion | Registered Nurse | 1011 South Texas 6, Suite 311, Houston, TX 77077 | 2018-08-15 |
| 1548753536 | Jasmine M Mckenzie | Specialist | 12350 Westhemier Rd, Suite 128, Houston, TX 77077 | 2018-06-13 |
| 1396233698 | Waabeke Charlotte Nwikpo | Counselor | 1919 S Kirkwood Rd Apt 144, Houston, TX 77077 | 2018-04-23 |
| 1447747894 | Westside Medical Centers of Texas Pllc | Chiropractor | 1137 Highway 6 South, Houston, TX 77077 | 2018-04-20 |
| 1649786427 | Medical Care Innovation, P.C. | Clinic/Center | 1254 Enclave Parkway, Houston, TX 77077 | 2017-12-16 |
| 1649602962 | Bereket Haileab Tsegai | Optometrist | 11660 Westheimer Rd Ste 125, Houston, TX 77077 | 2013-08-09 |
| 1851733273 | Tomekia Alvarez | Occupational Therapy Assistant | 1815 Enclave Parkway, Apt 6307, Houston, TX 77077 | 2013-07-26 |
| 1134418551 | Telja Unlimited | Pharmacy | 12827 Westheimer Rd, Houston, TX 77077 | 2011-04-06 |
| Find all providers in zip 77077 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447865936 | Zhuoxuan Judy Cai | Student in an Organized Health Care Education/Training Program | 1400 Pressler St Fl 7703015, Houston, TX 77030-3722 | 2020-09-10 |
| 1255946109 | Idris Abdullah Badruddin | Student in an Organized Health Care Education/Training Program | 7911 Lawn Wood Ln, Houston, TX 77086-2325 | 2020-09-08 |
| 1427669209 | Omar Ahmed | Student in an Organized Health Care Education/Training Program | 7500 Cambridge St # 6510, Houston, TX 77054-2032 | 2020-08-13 |
| 1245840503 | Punit Pala | Student in an Organized Health Care Education/Training Program | 1550 Lakeside Enclave Dr, Houston, TX 77077-1684 | 2020-08-03 |
| 1932719374 | Atteeba Manzar | Student in an Organized Health Care Education/Training Program | 6550 Fannin St Ste 1661, Houston, TX 77030-2765 | 2020-07-31 |
| 1619595204 | Noah Collaco | Student in an Organized Health Care Education/Training Program | 3110 Gannett St, Houston, TX 77025-3826 | 2020-07-09 |
| 1629696273 | Esraa Elsamny | Student in an Organized Health Care Education/Training Program | 7676 Phoenix Dr Apt 1523, Houston, TX 77030-4725 | 2020-07-09 |
| 1194343988 | Melanie Leigh Painter | Student in an Organized Health Care Education/Training Program | 1505 City Nights Way, Houston, TX 77047-3405 | 2020-07-08 |
| 1467079608 | Emmanuella Adetoro Oduguwa | Student in an Organized Health Care Education/Training Program | 10918 Ranier Dr, Houston, TX 77031-1835 | 2020-07-04 |
| 1366069288 | Jacob Charles Kinskey | Student in an Organized Health Care Education/Training Program | Attn: Jacob Kinskey, Dept. of Pathology, 6550 Fannin St Ste Sm383, Houston, TX 77030-2717 | 2020-06-26 |
| Find all providers in HOUSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.