Provider Demographics
NPI:1164869103
Name:POON, TIMOTHY WAI-YAN (RN, NP-C)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:WAI-YAN
Last Name:POON
Suffix:
Gender:M
Credentials:RN, NP-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8307 KNIGHT RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-3905
Mailing Address - Country:US
Mailing Address - Phone:281-468-5008
Mailing Address - Fax:832-779-8623
Practice Address - Street 1:2626 S LOOP W STE 265
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-5636
Practice Address - Country:US
Practice Address - Phone:713-796-9955
Practice Address - Fax:713-796-9779
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX743390363LF0000X
TXAP123675363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
743390OtherAPRN LICENSE