Individual
DR. DIVINA M TUAZON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6565 FANNIN ST, SUITE B452, HOUSTON, TX 77030-2703
(713) 441-3620
(713) 790-2082
Mailing address
6565 FANNIN ST, SUITE B452, HOUSTON, TX 77030-2703
(713) 441-3620
(713) 790-2082
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
L8218
TX
207RP1001X
Pulmonary Disease Physician
L8218
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1669457826
BLUE CROSS BLUE SHIELD
TX
05
—
181147303
—
TX
01
—
2319400
LA MEDICAID
LA
01
—
P01078450
RR MEDICARE
TX
Enumeration date
12/09/2005
Last updated
01/24/2013
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