Provider Demographics
NPI:1235905886
Name:BETTS, TANDRA M
Entity Type:Individual
Prefix:MRS
First Name:TANDRA
Middle Name:M
Last Name:BETTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5716 WIMBLEDON CIR
Mailing Address - Street 2:
Mailing Address - City:HALTOM CITY
Mailing Address - State:TX
Mailing Address - Zip Code:76137-6221
Mailing Address - Country:US
Mailing Address - Phone:217-553-6044
Mailing Address - Fax:
Practice Address - Street 1:5716 WIMBLEDON CIR
Practice Address - Street 2:
Practice Address - City:HALTOM CITY
Practice Address - State:TX
Practice Address - Zip Code:76137-6221
Practice Address - Country:US
Practice Address - Phone:217-553-6044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula