MEDICARE: TABBASUM FATIMA

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
1	376J00000X	Homemaker	2614836	TX

General Provider Information

NPI Number	:	1679281497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TABBASUM FATIMA

Provider Business Mailing Address
First Line	:	6301 SIERRA BLANCA DR APT 5201
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-7508
Country	:	US
Telephone Number	:	346-775-2897
Fax Number	:

Provider Business Practice Location Address
First Line	:	6301 SIERRA BLANCA DR APT 5201
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-7508
Country	:	US
Telephone Number	:	346-775-2897
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2022
Last Update Date	:	11/10/2022

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Directions to “ TABBASUM FATIMA ” Practice Location

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