Provider Demographics
NPI:1558605667
Name:TIG HEALTHCARE AND DIAGNOSTIC CLINIC INC.
Entity Type:Organization
Organization Name:TIG HEALTHCARE AND DIAGNOSTIC CLINIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:OBINNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-774-1550
Mailing Address - Street 1:8449 W BELLFORT ST STE 330
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-2247
Mailing Address - Country:US
Mailing Address - Phone:713-774-1550
Mailing Address - Fax:713-774-1595
Practice Address - Street 1:8449 W BELLFORT ST STE 330
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-2247
Practice Address - Country:US
Practice Address - Phone:713-774-1550
Practice Address - Fax:713-774-1595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX570251261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service