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General NPI Number Information
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NPI Number | 1609525286
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Entity Type | Individual
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Provider Name | TIFFANY DEVEREAUX RN
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Gender | Female
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Dates
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Enumeration Date | 03/22/2022
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Last Update Date | 03/22/2022
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Provider Practice Location Address
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Address Line | 2833 ROBIN HILL LN
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City | GARLAND
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State | TX
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Zip | 75044-5949
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Country | US
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Telephone | 972-978-1965
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Fax |
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Provider Business Mailing Address
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Address Line | 5435 N GARLAND AVE # 140137
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City | GARLAND
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State | TX
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Zip | 75040-2785
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Country | US
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Telephone |
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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 | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | 702480
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License Number State | TX
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