MEDICARE: TYESHA HOPE

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	251C00000X	Developmentally Disabled Services Day Training Agency		TX

General Provider Information

NPI Number	:	1578423133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYESHA HOPE

Provider Business Mailing Address
First Line	:	9525 GROSS ST
Second Line	:
City	:	BEAUMONT
State	:	TX
Zip	:	77707-1148
Country	:	US
Telephone Number	:	409-466-8557
Fax Number	:	409-466-8557

Provider Business Practice Location Address
First Line	:	9525 GROSS ST
Second Line	:
City	:	BEAUMONT
State	:	TX
Zip	:	77707-1148
Country	:	US
Telephone Number	:	409-466-8557
Fax Number	:	409-466-8557

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

Provider Enumeration Date	:	11/17/2025
Last Update Date	:	12/07/2025

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Directions to “ TYESHA HOPE ” Practice Location

Language	Start Address	Practice Location

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