Provider Demographics
NPI:1366832925
Name:COLE, TAMIKA MONIQUE (PA-C)
Entity Type:Individual
Prefix:
First Name:TAMIKA
Middle Name:MONIQUE
Last Name:COLE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18914 PADDLEFISH WAY
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-7016
Mailing Address - Country:US
Mailing Address - Phone:832-654-3473
Mailing Address - Fax:281-895-3083
Practice Address - Street 1:8600 HIGHWAY 6 NORTH
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095
Practice Address - Country:US
Practice Address - Phone:832-654-3473
Practice Address - Fax:281-895-3083
Is Sole Proprietor?:No
Enumeration Date:2015-02-03
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA09590363AM0700X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical