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General NPI Number Information
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NPI Number | 1457727885
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Entity Type | Individual
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Provider Name | TANNER ISAAK STEED PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/19/2015
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Last Update Date | 12/15/2022
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Provider Practice Location Address
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Address Line | 800 PEAKWOOD DR STE 5D
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City | HOUSTON
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State | TX
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Zip | 77090-2903
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Country | US
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Telephone | 832-353-2498
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Fax |
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Provider Business Mailing Address
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Address Line | 800 PEAKWOOD DR STE 5D
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City | HOUSTON
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State | TX
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Zip | 77090-2903
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Country | US
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Telephone | 832-353-2498
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 59729
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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