Individual
JONATHAN TEBOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4707 BLACK STONE ST, BAYTOWN, TX 77521-8535
(409) 665-5023
Mailing address
4707 BLACK STONE ST, BAYTOWN, TX 77521-8535
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/18/2023
Last updated
08/04/2023
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