Provider Demographics
NPI:1184491698
Name:HYMAN, TAHIRA ABIOLA
Entity type:Individual
Prefix:
First Name:TAHIRA
Middle Name:ABIOLA
Last Name:HYMAN
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 1:112 HARVEST ROW CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-8416
Mailing Address - Country:US
Mailing Address - Phone:919-673-9779
Mailing Address - Fax:
Practice Address - Street 1:8801 FAST PARK DR STE 301
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-4853
Practice Address - Country:US
Practice Address - Phone:919-442-8398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL007578133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered