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General NPI Number Information
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NPI Number | 1861015547
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Entity Type | Individual
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Provider Name | TAMIKO GRIFFIN
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Gender | Female
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Dates
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Enumeration Date | 05/28/2020
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Last Update Date | 05/28/2020
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Provider Practice Location Address
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Address Line | 332 COUNTY ROAD 1150
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City | KENNARD
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State | TX
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Zip | 75847-5809
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Country | US
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Telephone | 936-215-9004
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Fax |
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Provider Business Mailing Address
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Address Line | 1155 DAIRY ASHFORD RD STE 560
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City | HOUSTON
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State | TX
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Zip | 77079-3035
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Country | US
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Telephone | 713-799-2200
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 748053
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License Number State | TX
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