Individual
MR. LUIS HUMBERTO TAMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSISIAN ASSISTANT
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA04091
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L0143546
DPS REGISTRATION NUMBER
TX
01
—
PA04091
PHYSICIAN ASSISTANT PERMI
TX
Enumeration date
12/14/2006
Last updated
07/08/2007
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