Provider Demographics
NPI:1215406970
Name:THOMAS, TENEISHA ANDREA (LVN)
Entity Type:Individual
Prefix:
First Name:TENEISHA
Middle Name:ANDREA
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18021 KINGSLAND BLVD APT 9110
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094-2012
Mailing Address - Country:US
Mailing Address - Phone:281-900-4771
Mailing Address - Fax:
Practice Address - Street 1:18021 KINGSLAND BLVD APT 9110
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094-2012
Practice Address - Country:US
Practice Address - Phone:281-900-4771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-24
Last Update Date:2018-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX204487164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse