Provider Demographics
NPI:1689189367
Name:COUTEE, TAIRRA LANEA
Entity Type:Individual
Prefix:
First Name:TAIRRA
Middle Name:LANEA
Last Name:COUTEE
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 1:15627 KIPPERS DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014-1543
Mailing Address - Country:US
Mailing Address - Phone:832-375-0808
Mailing Address - Fax:
Practice Address - Street 1:15627 KIPPERS DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-1543
Practice Address - Country:US
Practice Address - Phone:832-375-0808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-04
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX823589822Medicaid