Provider Demographics
NPI:1578234563
Name:TIGIST MEHARI MD PLLC
Entity Type:Organization
Organization Name:TIGIST MEHARI MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIGIST
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-684-0069
Mailing Address - Street 1:26400 KUYKENDAHL RD STE C180-135
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77375-2882
Mailing Address - Country:US
Mailing Address - Phone:510-684-0069
Mailing Address - Fax:817-977-9583
Practice Address - Street 1:150 PINE FOREST DR STE 501
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-5304
Practice Address - Country:US
Practice Address - Phone:510-684-0069
Practice Address - Fax:817-977-9583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty