Individual
TOMITAMUNOKUMA ISOBO TARIAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11931 S HIGHWAY 6, SUGAR LAND, TX 77498-5727
(832) 461-2447
Mailing address
13106 BRUTUS HILL LN, HOUSTON, TX 77072-0108
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1119126
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29157646
TEXAS DEPARTMENT OF PUBLIC SAFETY
TX
Enumeration date
01/08/2024
Last updated
01/08/2024
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