Individual
RAFAELLE W TKAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1507 W BAY AREA BLVD STE 116, WEBSTER, TX 77598-3404
(346) 617-8993
Mailing address
1507 W BAY AREA BLVD STE 116, WEBSTER, TX 77598-3404
(346) 617-8993
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
940461
TX
363L00000X
Nurse Practitioner
Primary
1111882
TX
Other
Enumeration date
08/30/2018
Last updated
12/07/2024
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