Provider Demographics
NPI:1033933791
Name:DUCKWORTH, RELUNDA ATCHISON
Entity type:Individual
Prefix:MRS
First Name:RELUNDA
Middle Name:ATCHISON
Last Name:DUCKWORTH
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 1:5803 RIDGEWAY DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77033-2127
Mailing Address - Country:US
Mailing Address - Phone:832-325-8938
Mailing Address - Fax:
Practice Address - Street 1:5005 1/2 LARKSPUR ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77033-3924
Practice Address - Country:US
Practice Address - Phone:832-325-8938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX143608023747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant