Provider Demographics
NPI:1639267123
Name:TURNER, TAMMIE (MD)
Entity Type:Individual
Prefix:DR
First Name:TAMMIE
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 N 19TH ST
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76708-2007
Mailing Address - Country:US
Mailing Address - Phone:254-745-5105
Mailing Address - Fax:254-745-5137
Practice Address - Street 1:3501 N 19TH ST
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-2097
Practice Address - Country:US
Practice Address - Phone:254-745-5105
Practice Address - Fax:254-745-5137
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2852174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist