Provider Demographics
NPI:1144033598
Name:MORRIS, TINA MIRACLES
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:MIRACLES
Last Name:MORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:MIRACLES
Other - Last Name:OGIATOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12042 AUCKLAND PT
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-7412
Mailing Address - Country:US
Mailing Address - Phone:832-873-3997
Mailing Address - Fax:
Practice Address - Street 1:12042 AUCKLAND PT
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-7412
Practice Address - Country:US
Practice Address - Phone:832-873-3997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX749493336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy