Provider Demographics
NPI:1700600855
Name:MCCOY, TIFFANY
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:MCCOY
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 1:9826 BALSAM LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77078-3106
Mailing Address - Country:US
Mailing Address - Phone:832-729-1978
Mailing Address - Fax:
Practice Address - Street 1:9826 BALSAM LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77078-3106
Practice Address - Country:US
Practice Address - Phone:832-729-1978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-14
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
No347C00000XTransportation ServicesPrivate Vehicle