Individual
TANISHA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12111 SAN LUCA ST, RICHMOND, TX 77406-1542
(713) 882-7223
Mailing address
PO BOX 840853, DALLAS, TX 75284-0863
(713) 620-4000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
M1117
TX
208D00000X
General Practice Physician
Primary
M1117
TX
Other
Enumeration date
10/02/2006
Last updated
08/02/2021
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