Individual
TYISHA BARRETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MMS, PA-C
Contact information
Practice address
2002 HOLCOMBE BLVD, HOUSTON, TX 77030-4211
(281) 794-1426
Mailing address
7023 KAYLEIGH CT, SUGAR LAND, TX 77479-5534
(281) 794-1426
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
PA14871
TX
363A00000X
Physician Assistant
PA14871
TX
363AM0700X
Medical Physician Assistant
PA14871
TX
363AS0400X
Surgical Physician Assistant
Primary
PA14871
TX
Other
Enumeration date
10/07/2021
Last updated
10/07/2021
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