Provider Demographics
NPI:1194314286
Name:TOMAGWA MINISTRIES, INC
Entity type:Organization
Organization Name:TOMAGWA MINISTRIES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIMIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-559-5223
Mailing Address - Street 1:455 SCHOOL ST STE 30
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-4595
Mailing Address - Country:US
Mailing Address - Phone:832-559-5233
Mailing Address - Fax:
Practice Address - Street 1:18230 FM 1488 RD STE 203
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-4530
Practice Address - Country:US
Practice Address - Phone:832-559-5260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOMAGWA MINISTIRES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-13
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty