Provider Demographics
NPI:1184053902
Name:BRILLIANTLY BABY
Entity type:Organization
Organization Name:BRILLIANTLY BABY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DECHELLE
Authorized Official - Middle Name:P
Authorized Official - Last Name:PIERSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:832-224-6304
Mailing Address - Street 1:10190 KATY FWY STE 450
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-5297
Mailing Address - Country:US
Mailing Address - Phone:832-224-6304
Mailing Address - Fax:
Practice Address - Street 1:10190 KATY FWY STE 450
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77043-5297
Practice Address - Country:US
Practice Address - Phone:832-224-6304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1001183261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health