Provider Demographics
NPI:1518619741
Name:CHARGOIS, TAWANNA THOMPSON (RN)
Entity Type:Individual
Prefix:MS
First Name:TAWANNA
Middle Name:THOMPSON
Last Name:CHARGOIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1562
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77347-1562
Mailing Address - Country:US
Mailing Address - Phone:281-235-9247
Mailing Address - Fax:346-273-2168
Practice Address - Street 1:12307 GOLDEN OASIS LN
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-4183
Practice Address - Country:US
Practice Address - Phone:281-235-9247
Practice Address - Fax:346-273-2168
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX902000163WC1500X, 291U00000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Multi-Specialty
No291U00000XLaboratoriesClinical Medical Laboratory