Provider Demographics
NPI:1891195871
Name:MAHAN BELL, TAMARA
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:MAHAN BELL
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:PO BOX 20112
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-0112
Mailing Address - Country:US
Mailing Address - Phone:832-264-6765
Mailing Address - Fax:832-383-1554
Practice Address - Street 1:3001 DOVE COUNTRY DR
Practice Address - Street 2:APT. 1804
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-6027
Practice Address - Country:US
Practice Address - Phone:832-264-6765
Practice Address - Fax:832-383-1554
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program