Healthcare Provider Details

I. General information

NPI: 1164261590
Provider Name (Legal Business Name): MS. TIYOSHA TURNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2024
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 W TIDWELL RD STE 120
HOUSTON TX
77091-4356
US

IV. Provider business mailing address

509 W TIDWELL RD STE 100
HOUSTON TX
77091-4353
US

V. Phone/Fax

Practice location:
  • Phone: 713-694-6447
  • Fax:
Mailing address:
  • Phone: 713-694-6447
  • Fax: 713-492-0864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number978487
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1164309
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number1164309
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: