Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086X0206X | Surgical Oncologist | PA14871 | TX |
NPI | 1225790132 |
---|---|
Provider Name | Tyisha Barrett |
First Address | Sugar Land, TX 77479-5534 |
Second Address | Houston, TX 77030-4211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2021 |
Last Update Date | 07/10/2021 |