Goriola Tony Shotomiwa
Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition in Houston, TX. Individual provider (NPI-1).
NPI number1629314489
StatusActive
Last updated in NPPESDec 26, 2012
Details
- NPI
- 1629314489
- Entity type
- Individual (NPI-1)
- Name
- Goriola Tony Shotomiwa
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 26, 2012
- Last updated
- Dec 26, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332BP3500X | Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | 36239122 | TX | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 36239122 | TX | |
| 332BX2000X | Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies | 36239122 | TX |
Practice location
6814 Stableton LnHouston, TX 77049-2054
Phone 713-542-7438
Mailing address
6814 Stableton LnHouston, TX 77049-2054
Phone 713-542-7438
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