Provider Demographics
NPI:1558951517
Name:ROBINSON, DEKOSHA NICOLE
Entity Type:Individual
Prefix:
First Name:DEKOSHA
Middle Name:NICOLE
Last Name:ROBINSON
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 1:4444 CYPRESS CREEK PKWY STE 30
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77068-3452
Mailing Address - Country:US
Mailing Address - Phone:346-316-1104
Mailing Address - Fax:
Practice Address - Street 1:4444 CYPRESS CREEK PKWY STE 30
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068-3452
Practice Address - Country:US
Practice Address - Phone:346-316-1104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-24
Last Update Date:2021-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty