Provider Demographics
NPI:1215248851
Name:SWEET, VICTOR L
Entity type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:L
Last Name:SWEET
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4830 WILSON RD
Mailing Address - Street 2:SUITE 300 #167
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-1971
Mailing Address - Country:US
Mailing Address - Phone:281-782-9804
Mailing Address - Fax:713-491-3319
Practice Address - Street 1:8123 RICHLAND DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77028-1941
Practice Address - Country:US
Practice Address - Phone:713-931-6254
Practice Address - Fax:713-491-3319
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator