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General NPI Number Information
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NPI Number | 1114685898
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Entity Type | Individual
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Provider Name | RENEE B ISIAHILIZA CHW
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Gender | Female
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Dates
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Enumeration Date | 11/30/2021
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Last Update Date | 11/30/2021
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Provider Practice Location Address
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Address Line | 110 ROCKLEIGH PL
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City | HOUSTON
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State | TX
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Zip | 77017-2516
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Country | US
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Telephone | 346-352-3118
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Fax |
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Provider Business Mailing Address
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Address Line | 110 ROCKLEIGH PL
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City | HOUSTON
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State | TX
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Zip | 77017-2516
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | 9467
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License Number State | TX
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