Provider Demographics
NPI:1548452014
Name:TIEASHA DUKES
Entity type:Organization
Organization Name:TIEASHA DUKES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TIEASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:RMT
Authorized Official - Phone:281-704-9454
Mailing Address - Street 1:503 ROSEN AVE
Mailing Address - Street 2:
Mailing Address - City:ARCOLA
Mailing Address - State:TX
Mailing Address - Zip Code:77583-2752
Mailing Address - Country:US
Mailing Address - Phone:281-704-9454
Mailing Address - Fax:281-431-1058
Practice Address - Street 1:503 ROSEN AVE
Practice Address - Street 2:
Practice Address - City:ARCOLA
Practice Address - State:TX
Practice Address - Zip Code:77583-2752
Practice Address - Country:US
Practice Address - Phone:281-704-9454
Practice Address - Fax:281-431-1058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT102100251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health