Provider Demographics
NPI:1023433737
Name:RUSSELL, TAMEKA
Entity type:Individual
Prefix:
First Name:TAMEKA
Middle Name:
Last Name:RUSSELL
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:P.O. BOX 16338
Mailing Address - Street 2:FOREVER ORCHID HOME HEALTHCARE
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77222
Mailing Address - Country:US
Mailing Address - Phone:281-690-6751
Mailing Address - Fax:
Practice Address - Street 1:13333 NORTHBOROUGH DR APT 716
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77067-1738
Practice Address - Country:US
Practice Address - Phone:281-690-6751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-04
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health