Provider Demographics
NPI:1922625243
Name:ROBERTS, TERI LYNN
Entity Type:Individual
Prefix:
First Name:TERI
Middle Name:LYNN
Last Name:ROBERTS
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 1:12706 BANCHORY LEAF DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-4920
Mailing Address - Country:US
Mailing Address - Phone:713-315-0394
Mailing Address - Fax:
Practice Address - Street 1:11944 VETERANS MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77067-1834
Practice Address - Country:US
Practice Address - Phone:281-223-1197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-02
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist