Individual
EDWIN TOMENIO TAGAB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
3007 MUSTANG MEADOW LN, MANVEL, TX 77578-4279
(214) 493-3454
Mailing address
3007 MUSTANG MEADOW LN, MANVEL, TX 77578-4279
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
026-0032593
VT
163W00000X
Registered Nurse
088709
CT
163W00000X
Registered Nurse
Primary
735061
TX
163W00000X
Registered Nurse
838832
CA
163W00000X
Registered Nurse
RN75702
NV
Other
Enumeration date
06/17/2013
Last updated
06/17/2013
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