Provider Demographics
NPI:1790134146
Name:STOWERS, TABATHA
Entity Type:Individual
Prefix:
First Name:TABATHA
Middle Name:
Last Name:STOWERS
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 1:1810 E PETERS COLONY RD
Mailing Address - Street 2:APT 7008
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-3705
Mailing Address - Country:US
Mailing Address - Phone:615-601-4894
Mailing Address - Fax:
Practice Address - Street 1:1810 E PETERS COLONY RD
Practice Address - Street 2:APT 7008
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-3705
Practice Address - Country:US
Practice Address - Phone:615-601-4894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other