Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 29802 | TX |
NPI | 1376808451 |
---|---|
Provider Name | Tameka Knight |
First Address | Humble, TX 77346-3130 |
Second Address | Humble, TX 77346-3130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2012 |
Last Update Date | 12/03/2015 |