NPI | 1750170809 |
---|---|
Entity Type | Organization |
Authorized Contact | TANISHA MANGON Owner 832-334-8427 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care |
363LA2200X Nurse Practitioner, Adult Health | |
363LG0600X Nurse Practitioner, Gerontology | |
Enumeration Date | 2025-05-05 |
Last Update Date | 2025-07-11 |