Individual
ISAMU TACHIBANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2001 INWOOD RD, DALLAS, TX 75390-5116
(214) 645-8765
Mailing address
535 BARNHILL DR, INDIANAPOLIS, IN 46202-5116
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
01086000A
IN
208800000X
Urology Physician
Primary
U3028
TX
390200000X
Student in an Organized Health Care Education/Training Program
11018895A
IN
Other
Enumeration date
06/09/2016
Last updated
09/18/2023
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