MEDICARE: TREMETRIE VIRGINIA WALKER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1972389468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TREMETRIE VIRGINIA WALKER

Provider Business Mailing Address
First Line	:	3811 RICHLAND DR
Second Line	:
City	:	FARMERSVILLE
State	:	TX
Zip	:	75442-7232
Country	:	US
Telephone Number	:	682-365-3763
Fax Number	:

Provider Business Practice Location Address
First Line	:	405 STATE HIGHWAY 121 BYP STE 250
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75067-4183
Country	:	US
Telephone Number	:	682-365-3763
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2023
Last Update Date	:	02/18/2026

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