Provider Demographics
NPI:1982082517
Name:THOMAS-HOCKADAY, JEREKA RENEE (CSFA)
Entity Type:Individual
Prefix:
First Name:JEREKA
Middle Name:RENEE
Last Name:THOMAS-HOCKADAY
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13203 VIENTO DEL SUR ST
Mailing Address - Street 2:
Mailing Address - City:MANCHACA
Mailing Address - State:TX
Mailing Address - Zip Code:78652-4721
Mailing Address - Country:US
Mailing Address - Phone:832-597-2121
Mailing Address - Fax:512-692-9140
Practice Address - Street 1:13203 VIENTO DEL SUR ST
Practice Address - Street 2:
Practice Address - City:MANCHACA
Practice Address - State:TX
Practice Address - Zip Code:78652-4721
Practice Address - Country:US
Practice Address - Phone:832-597-2121
Practice Address - Fax:512-692-9140
Is Sole Proprietor?:No
Enumeration Date:2015-05-14
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant