Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 688280 | TX |
NPI | 1083046569 |
---|---|
Provider Name | Tiffany Choate |
First Address | Cypress, TX 77433-3504 |
Second Address | Houston, TX 77054-1906 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2013 |
Last Update Date | 14/03/2014 |