Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | OH57010911 | OH |
NPI | 1396812749 |
---|---|
Provider Name | Tiffany Powell Raynor |
First Address | Houston, TX 77033-2725 |
Second Address | Houston, TX 77033-2725 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 08/07/2007 |