Provider Demographics
NPI:1811753890
Name:MCCLAIN, TANEKA
Entity type:Individual
Prefix:
First Name:TANEKA
Middle Name:
Last Name:MCCLAIN
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 1:1043 MARCOLIN ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77088-5168
Mailing Address - Country:US
Mailing Address - Phone:832-560-4992
Mailing Address - Fax:
Practice Address - Street 1:1043 MARCOLIN ST UNIT B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77088-5168
Practice Address - Country:US
Practice Address - Phone:832-560-4992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty