Individual
TARA NICOLE HUCKABEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
6441 HIGH STAR, HOUSTON, TX 77074
(832) 548-5000
Mailing address
PO BOX 66308, HOUSTON, TX 77266-6308
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
686841
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080462703
—
TX
Enumeration date
09/10/2010
Last updated
09/04/2013
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