Provider Demographics
NPI:1609280171
Name:TOGUCHI, TIMOTHY JO (FNP - BC)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:JO
Last Name:TOGUCHI
Suffix:
Gender:M
Credentials:FNP - BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5050 CRENSHAW RD STE 100
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-3139
Mailing Address - Country:US
Mailing Address - Phone:832-399-4141
Mailing Address - Fax:281-487-8824
Practice Address - Street 1:5050 CRENSHAW RD STE 100
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-3139
Practice Address - Country:US
Practice Address - Phone:832-399-4141
Practice Address - Fax:281-487-8824
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP125716363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily