Provider Demographics
NPI:1831675701
Name:LLOYD, TAHIRAH
Entity Type:Individual
Prefix:
First Name:TAHIRAH
Middle Name:
Last Name:LLOYD
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 1:1550 WESTBOROUGH DR APT 9308
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-2299
Mailing Address - Country:US
Mailing Address - Phone:832-243-2431
Mailing Address - Fax:
Practice Address - Street 1:1550 WESTBOROUGH DR APT 9308
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-2299
Practice Address - Country:US
Practice Address - Phone:832-243-2431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-13
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137340363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily