Devonda Chantal Wynn

Primary specialty

Phlebotomy TechnicianTaxonomy code 246RP1900X

License

CPT19-7289 Issued in TX

Practice address

16800 Imperial Valley Dr Ste 280
Houston, TX 77060-3161

Phone

(832) 910-7304

Fax

(832) 565-1193

NPI assigned

Dec 11, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1902444730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16800 IMPERIAL VALLEY DR STE 280",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770603161",
            "telephone_number": "832-910-7304",
            "fax_number": "832-565-1193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16800 IMPERIAL VALLEY DR STE 280",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770603161",
            "telephone_number": "832-910-7304",
            "fax_number": "832-565-1193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "DEVONDA",
        "middle_name": "CHANTAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-11",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "TX",
            "license": "CPT19-7289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMERCIAL INSURANCE",
            "identifier": "00000",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Houston",
            "affiliation": "N",
            "endpointDescription": "1labtestandmore@gmail.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "16800 Imperial Valley Dr Ste 280",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770603161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lauren Wyman, MA
• Chelsea Wynder, RN
• Joanna Michelle Apolinar Wynekus, PT
• Bob Wynn, M.D.
• Carolyn Wynn, LCSW, LMFT
• Kiiuristi Rasheedah Wynn
• Kyla Jones Wynn, NP
• Ryann Wynn, PA-C
• Tina Marie Wynn, RD, LD
• Wesly Woodson Wynn, LPC

• Phlebotomy Technician in Houston, TX
• Providers in Houston, TX by specialty
• Phlebotomy Technician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.