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NPI Code Detail

MEDICARE: TIARA MARIE RUNYON

MEDICARE: TIARA MARIE RUNYON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorTX

General Provider Information

NPI Number : 1043706336
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIARA MARIE RUNYON
Provider Business Mailing Address
First Line : 5225 KATY FWY STE 103
Second Line :
City : HOUSTON
State : TX
Zip : 77007-2263
Country : US
Telephone Number : 832-225-8518
Fax Number :
Provider Business Practice Location Address
First Line : 5225 KATY FWY STE 103
Second Line :
City : HOUSTON
State : TX
Zip : 77007-2263
Country : US
Telephone Number : 832-225-8518
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2018
Last Update Date : 02/03/2023

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Directions to “ TIARA MARIE RUNYON ” Practice Location

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