Provider Demographics
NPI:1992391999
Name:TAHMAHKERA, DEBRA (RNFA)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:TAHMAHKERA
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 938
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75030-0938
Mailing Address - Country:US
Mailing Address - Phone:214-227-2457
Mailing Address - Fax:214-764-0880
Practice Address - Street 1:1555 BROAD VALLEY DR
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-6565
Practice Address - Country:US
Practice Address - Phone:817-929-6050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-15
Last Update Date:2021-03-18
Deactivation Date:2020-12-15
Deactivation Code:
Reactivation Date:2021-03-02
Provider Licenses
StateLicense IDTaxonomies
TX509642246ZC0007X, 163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant