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General NPI Number Information
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NPI Number | 1528829504
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Entity Type | Individual
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Provider Name | TEQUILA HOLMES CNA
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Gender | Female
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Dates
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Enumeration Date | 01/17/2024
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Last Update Date | 01/17/2024
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Provider Practice Location Address
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Address Line | 777 N POST OAK RD APT 610
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City | HOUSTON
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State | TX
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Zip | 77024-3806
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Country | US
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Telephone | 985-507-2655
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Fax |
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Provider Business Mailing Address
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Address Line | 13326 TARA OAK DR
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City | HOUSTON
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State | TX
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Zip | 77065-3739
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Country | US
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Telephone | 314-306-0248
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | NA0061010023
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License Number State | TX
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