Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | TX |
NPI | 1831441856 |
---|---|
Provider Name | Mrs. Tamara Andrea Ongongo |
First Address | Houston, TX 77072-1246 |
Second Address | Houston, TX 77072-1246 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2012 |
Last Update Date | 15/10/2012 |