Provider Demographics
NPI:1487405858
Name:EVANS, TAMINIKA
Entity type:Individual
Prefix:
First Name:TAMINIKA
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23502 HARPERGATE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-6717
Mailing Address - Country:US
Mailing Address - Phone:346-465-4186
Mailing Address - Fax:281-595-9065
Practice Address - Street 1:23502 HARPERGATE DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-6717
Practice Address - Country:US
Practice Address - Phone:346-465-4186
Practice Address - Fax:281-595-9065
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service