Provider Demographics
NPI:1285520783
Name:KING, TEAUNDRIA
Entity type:Individual
Prefix:
First Name:TEAUNDRIA
Middle Name:
Last Name:KING
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 1:9050 BOWRING PARK
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-2803
Mailing Address - Country:US
Mailing Address - Phone:210-838-0234
Mailing Address - Fax:210-838-0234
Practice Address - Street 1:7608 NARROW PASS ST
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3019
Practice Address - Country:US
Practice Address - Phone:210-714-3545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician