Provider Demographics
NPI:1346531381
Name:ADAMS, TAKEISHA
Entity Type:Individual
Prefix:MS
First Name:TAKEISHA
Middle Name:
Last Name:ADAMS
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:PO BOX 2441
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77347-2441
Mailing Address - Country:US
Mailing Address - Phone:832-207-8500
Mailing Address - Fax:832-201-7970
Practice Address - Street 1:9603 ARBURY LN
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-4296
Practice Address - Country:US
Practice Address - Phone:832-207-8500
Practice Address - Fax:832-644-8406
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-25
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1346531381Medicaid
TX1346531381Medicaid