Provider Demographics
NPI:1144633900
Name:HATTON, THERESA (RN)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:HATTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6511 MARDALE DR
Mailing Address - Street 2:#A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77016-2210
Mailing Address - Country:US
Mailing Address - Phone:832-410-5607
Mailing Address - Fax:
Practice Address - Street 1:6511 MARDALE DR
Practice Address - Street 2:N/A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77016-2210
Practice Address - Country:US
Practice Address - Phone:832-410-5607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX246153171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator