Provider Demographics
NPI:1235858879
Name:HERSI, RATHEA AHMED
Entity Type:Individual
Prefix:
First Name:RATHEA
Middle Name:AHMED
Last Name:HERSI
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 1:8107 AUTUMN TRACE CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-6943
Mailing Address - Country:US
Mailing Address - Phone:346-715-2878
Mailing Address - Fax:
Practice Address - Street 1:11525 S HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-4932
Practice Address - Country:US
Practice Address - Phone:281-565-4504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program