Provider Demographics
NPI:1033415310
Name:TABANGCURA, BRYON ISAAC
Entity Type:Individual
Prefix:MR
First Name:BRYON
Middle Name:ISAAC
Last Name:TABANGCURA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2224 LIME ST APT 4
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-4206
Mailing Address - Country:US
Mailing Address - Phone:808-205-2765
Mailing Address - Fax:
Practice Address - Street 1:2224 LIME ST APT 4
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-4206
Practice Address - Country:US
Practice Address - Phone:808-205-2765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-03
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst