Provider Demographics
NPI:1710153747
Name:MEADOWS SYKORA, TAMPA LOUISE (CDA,RDH)
Entity Type:Individual
Prefix:MRS
First Name:TAMPA
Middle Name:LOUISE
Last Name:MEADOWS SYKORA
Suffix:
Gender:F
Credentials:CDA,RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COMMANDER (HEALTH SERVICES) US COAST GUARD SECTOR
Mailing Address - Street 2:BLDG 101 SOUTH BROAD ST
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36615
Mailing Address - Country:US
Mailing Address - Phone:251-441-6242
Mailing Address - Fax:251-441-5498
Practice Address - Street 1:US COAST GUARD SECTOR SOUTH BROAD ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36615
Practice Address - Country:US
Practice Address - Phone:251-441-6242
Practice Address - Fax:251-441-5498
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2364124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist