Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 8424 | TX |
NPI | 1124336037 |
---|---|
Provider Name | Dr. Ama Tea |
First Address | Alief, TX 77411-0608 |
Second Address | Houston, TX 77072-1962 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2010 |
Last Update Date | 27/07/2012 |