Provider Demographics
NPI:1033141569
Name:TUAMOKUMO, NIMI L (MD)
Entity Type:Individual
Prefix:
First Name:NIMI
Middle Name:L
Last Name:TUAMOKUMO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8399
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77387-8399
Mailing Address - Country:US
Mailing Address - Phone:281-364-1707
Mailing Address - Fax:281-364-0028
Practice Address - Street 1:22710 PROFESSIONAL DR
Practice Address - Street 2:RADIATION DEPARTMENT
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-6008
Practice Address - Country:US
Practice Address - Phone:281-312-8545
Practice Address - Fax:281-348-8250
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2268882085R0001X
TXN05212085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1487887667OtherNPI
TX270573017OtherTAX ID
TX760528826OtherTAX ID
TX1255397733OtherNPI
TX1487887667OtherNPI
TX270573017OtherTAX ID
TX1255397733OtherNPI