Individual
TAMMY SHANAE BOULDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
E.M.T
Contact information
Practice address
5622 BRIDGE FOREST DR, HOUSTON, TX 77088-2820
(713) 378-1339
(281) 272-2484
Mailing address
5622 BRIDGE FOREST DR, HOUSTON, TX 77088-2820
(713) 378-1339
(281) 272-2484
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
150014
TX
Other
Enumeration date
10/13/2007
Last updated
10/13/2007
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