MEDICARE: TAIRRA LANEA COUTEE

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	343900000X	Non-emergency Medical Transport (VAN)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689189367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAIRRA LANEA COUTEE

Provider Business Mailing Address
First Line	:	15627 KIPPERS DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77014-1543
Country	:	US
Telephone Number	:	832-375-0808
Fax Number	:

Provider Business Practice Location Address
First Line	:	15627 KIPPERS DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77014-1543
Country	:	US
Telephone Number	:	832-375-0808
Fax Number	:

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

Provider Enumeration Date	:	12/04/2017
Last Update Date	:	12/04/2017

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Directions to “ TAIRRA LANEA COUTEE ” Practice Location

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