Provider Demographics
NPI:1780215954
Name:SOWE, TAMETHA
Entity Type:Individual
Prefix:
First Name:TAMETHA
Middle Name:
Last Name:SOWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 NORWOOD PL APT 1
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-7102
Mailing Address - Country:US
Mailing Address - Phone:901-338-4237
Mailing Address - Fax:
Practice Address - Street 1:500 NORWOOD PL APT 1
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-7102
Practice Address - Country:US
Practice Address - Phone:901-338-4237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X, 251J00000X, 372500000X
TX339232164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No372500000XNursing Service Related ProvidersChore Provider