Healthcare Provider Details

I. General information

NPI: 1891690848
Provider Name (Legal Business Name): MANUELA TINGBO-BETWA
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 CYPRESS CREEK PKWY STE 166
HOUSTON TX
77068-3414
US

IV. Provider business mailing address

20938 CORDELL LANDING DR
RICHMOND TX
77407-4089
US

V. Phone/Fax

Practice location:
  • Phone: 832-925-9529
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: