Provider Demographics
NPI:1609279231
Name:CLEAVER, DELANDRA
Entity Type:Individual
Prefix:
First Name:DELANDRA
Middle Name:
Last Name:CLEAVER
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 1:11515 BREMEN DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77066-4744
Mailing Address - Country:US
Mailing Address - Phone:832-607-2956
Mailing Address - Fax:
Practice Address - Street 1:11515 BREMEN DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77066-4744
Practice Address - Country:US
Practice Address - Phone:832-607-2956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-26
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator