Provider Demographics
NPI:1407243389
Name:ETUK, LINDA
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:
Last Name:ETUK
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 1:10614 PLAINFIELD ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031-1006
Mailing Address - Country:US
Mailing Address - Phone:713-962-9236
Mailing Address - Fax:713-995-7126
Practice Address - Street 1:9301 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1510
Practice Address - Country:US
Practice Address - Phone:713-962-9236
Practice Address - Fax:713-995-7126
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-18
Last Update Date:2015-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)