| Blue Angel | |
|
13510 Sorghum Dr Rosharon TX 77583-0437 | |
| (346) 262-7228 | |
| (346) 262-7228 |
| Full Name | Blue Angel |
|---|---|
| Speciality | Behavior Analyst |
| Location | 13510 Sorghum Dr, Rosharon, Texas |
| Authorized Official Name and Position | Liza Monette Lawrence (OWNER) |
| Authorized Official Contact | 3462627228 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Angel 13510 Sorghum Dr Rosharon TX 77583-0437 Ph: (346) 262-7228 | Blue Angel 13510 Sorghum Dr Rosharon TX 77583-0437 Ph: (346) 262-7228 |
| NPI Number | 1114897147 |
|---|---|
| Provider Enumeration Date | 11/05/2025 |
| Last Update Date | 11/05/2025 |
| Certification Date | 11/05/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114897147 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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