Provider Demographics
NPI:1336785526
Name:MARTEL, TAMIKA LASHEA
Entity Type:Individual
Prefix:
First Name:TAMIKA
Middle Name:LASHEA
Last Name:MARTEL
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 1:20903 ROXETTE CT
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-5613
Mailing Address - Country:US
Mailing Address - Phone:832-375-4884
Mailing Address - Fax:
Practice Address - Street 1:547 E DALLAS ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-7943
Practice Address - Country:US
Practice Address - Phone:832-375-4884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-22
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28488165374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide