Provider Demographics
NPI:1124777180
Name:MORRIS, LATRISHA MONIQUE
Entity type:Individual
Prefix:
First Name:LATRISHA
Middle Name:MONIQUE
Last Name:MORRIS
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 1:8030 FARTHING LN
Mailing Address - Street 2:
Mailing Address - City:ROSHARON
Mailing Address - State:TX
Mailing Address - Zip Code:77583-1148
Mailing Address - Country:US
Mailing Address - Phone:832-574-0144
Mailing Address - Fax:
Practice Address - Street 1:8030 FARTHING LN
Practice Address - Street 2:
Practice Address - City:ROSHARON
Practice Address - State:TX
Practice Address - Zip Code:77583-1148
Practice Address - Country:US
Practice Address - Phone:832-574-0144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-18
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
Provider Identifiers
StateIdentifier IDID TypeIssuer
823994203OtherOWNER