Provider Demographics
NPI:1841791175
Name:MORGAN, DELORES RENEA
Entity Type:Individual
Prefix:
First Name:DELORES
Middle Name:RENEA
Last Name:MORGAN
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 1:10770 BARELY LN APT 117
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-5963
Mailing Address - Country:US
Mailing Address - Phone:832-752-5270
Mailing Address - Fax:
Practice Address - Street 1:10770 BARELY LN APT 117
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-5963
Practice Address - Country:US
Practice Address - Phone:832-752-5270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA0008369364374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty