Provider Demographics
NPI:1154044097
Name:RASAKI-CARRIER, TOLANI AZIZAT
Entity type:Individual
Prefix:
First Name:TOLANI
Middle Name:AZIZAT
Last Name:RASAKI-CARRIER
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 1:4343 TAWNY TIMBER DR
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77386-4895
Mailing Address - Country:US
Mailing Address - Phone:260-446-9165
Mailing Address - Fax:
Practice Address - Street 1:119 MEDICAL PARK LN STE D
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-4980
Practice Address - Country:US
Practice Address - Phone:936-277-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1093611363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily