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General NPI Number Information
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NPI Number | 1962113159
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Entity Type | Individual
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Provider Name | TAMIKA CHERRON BUSH D.O.
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Gender | Female
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 12/08/2022
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Provider Practice Location Address
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Address Line | 21175 TOMBALL PKWY # 379
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City | HOUSTON
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State | TX
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Zip | 77070-1655
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Country | US
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Telephone | 833-497-9429
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Fax |
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Provider Business Mailing Address
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Address Line | 21175 TOMBALL PKWY STE 379
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City | HOUSTON
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State | TX
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Zip | 77070-1655
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Country | US
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Telephone | 432-701-0093
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | R0366
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 2008-01094
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | R0366
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License Number State | TX
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