Provider Demographics
NPI:1326606393
Name:AUSTIN, TIARA W
Entity Type:Individual
Prefix:
First Name:TIARA
Middle Name:W
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TIARA
Other - Middle Name:
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 251
Mailing Address - Street 2:
Mailing Address - City:NEW SARPY
Mailing Address - State:LA
Mailing Address - Zip Code:70078-0251
Mailing Address - Country:US
Mailing Address - Phone:504-346-5354
Mailing Address - Fax:
Practice Address - Street 1:129 9TH STREET
Practice Address - Street 2:
Practice Address - City:DESTREHAN
Practice Address - State:LA
Practice Address - Zip Code:70047
Practice Address - Country:US
Practice Address - Phone:504-346-5354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)