Provider Demographics
NPI:1477243178
Name:PRESTON, TATYANNA M
Entity Type:Individual
Prefix:
First Name:TATYANNA
Middle Name:M
Last Name:PRESTON
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 1:1325 FITZHUGH AVE UNIT 405
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-2742
Mailing Address - Country:US
Mailing Address - Phone:903-517-0301
Mailing Address - Fax:
Practice Address - Street 1:1325 FITZHUGH AVE UNIT 405
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-2742
Practice Address - Country:US
Practice Address - Phone:903-279-9796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide