Provider Demographics
NPI:1053191346
Name:DOUGLAS, TIAUNA LENEA
Entity type:Individual
Prefix:
First Name:TIAUNA
Middle Name:LENEA
Last Name:DOUGLAS
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 1:6730 FOREST MEWS CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77049-1561
Mailing Address - Country:US
Mailing Address - Phone:832-982-8750
Mailing Address - Fax:
Practice Address - Street 1:6730 FOREST MEWS CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77049-1561
Practice Address - Country:US
Practice Address - Phone:832-982-8750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1044694163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse