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General NPI Number Information
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NPI Number | 1639681661
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Entity Type | Organization
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Legal Business Name | TYMES HEALTHCARE COMPANY PLLC
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Dates
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Enumeration Date | 10/31/2017
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Last Update Date | 10/31/2017
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Provider Practice Location Address
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Address Line | 3440 RILEY FUZZEL RD STE 200
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City | SPRING
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State | TX
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Zip | 77386-4189
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Country | US
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Telephone | 832-652-7330
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Fax |
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Provider Business Mailing Address
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Address Line | 3440 RILEY FUZZEL RD STE 200
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City | SPRING
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State | TX
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Zip | 77386-4189
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Country | US
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Telephone | 832-652-7330
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NISHANO THOMAS
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Credential | DMD
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Telephone | 832-652-7330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 21579
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License Number State | TX
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