Healthcare Provider Details

I. General information

NPI: 1114386596
Provider Name (Legal Business Name): DANA OMARI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2016
Last Update Date: 02/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 GRAHAM DR SUITE B
TOMBALL TX
77375-6451
US

IV. Provider business mailing address

929 GRAHAM DR SUITE B
TOMBALL TX
77375-6451
US

V. Phone/Fax

Practice location:
  • Phone: 281-351-5548
  • Fax: 281-351-5020
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDT84072
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: