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Individual

MS. TIMI RENEE RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CSFA, LSA

Contact information

Practice address
14826 BEECHMOOR DR, HOUSTON, TX 77095-3304
(713) 705-7953
(832) 478-9266
Mailing address
14826 BEECHMOOR DR, HOUSTON, TX 77095-3304
(713) 705-7953
(832) 478-9266

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
135207
NATIONAL BOARD OF SURGICAL TECHNOLOGIST AND SURGICAL ASSISTANTS
01
SA00720
TEXAS MEDICAL BOARD
TX
Enumeration date
07/09/2012
Last updated
04/08/2020
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