Provider Demographics
NPI:1245778273
Name:NORIA, TERESA MARICELA
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:MARICELA
Last Name:NORIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:A
Other - Middle Name:HEART OF GOLD,
Other - Last Name:HCS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:21426 CHESTER CLIFF LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-6462
Mailing Address - Country:US
Mailing Address - Phone:832-366-6763
Mailing Address - Fax:
Practice Address - Street 1:21426 CHESTER CLIFF LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-6462
Practice Address - Country:US
Practice Address - Phone:832-366-6763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-09
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25881727320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities