Broadway, Tila

Broadway, Tila is an individual health care provider with primary practice located at 23802 Highway 59 N , Kingwood TX 77339-1510. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology, which is considered as her primary health care specialty. Broadway, Tila can be contacted via phone (281) 312-5400.

Contact Information

Primary practice address
23802 Highway 59 N Kingwood TX 77339-1510
Phone: (281) 312-5400
Fax: (281) 312-5400
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology 363LX0001X AP125930 Texas

Profile Details

NPI number 1699183954
LBN Legal business name Broadway, Tila
Credentials WHNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 30th, 2014
Last updated Mar 26th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699183954 NPPES
Texas Other 8104NK BCBS

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