Provider Demographics
NPI:1508678830
Name:TAMBE TEKU, PAULYNE AGBE
Entity type:Individual
Prefix:
First Name:PAULYNE
Middle Name:AGBE
Last Name:TAMBE TEKU
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 1:313 CUMBERLAND FOREST DR
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77354-7218
Mailing Address - Country:US
Mailing Address - Phone:240-354-8340
Mailing Address - Fax:
Practice Address - Street 1:1207 N HOUSTON AVE STE A
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-2592
Practice Address - Country:US
Practice Address - Phone:281-570-2606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136795363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily