Provider Demographics
NPI:1194865121
Name:NOLLIE, DEVEREAUX LASHONTI (MD)
Entity type:Individual
Prefix:DR
First Name:DEVEREAUX
Middle Name:LASHONTI
Last Name:NOLLIE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3533 S ALAMEDA ST
Mailing Address - Street 2:2ND FLOOR HEALTH CENTER, SUITE H260
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411
Mailing Address - Country:US
Mailing Address - Phone:361-694-1550
Mailing Address - Fax:361-808-2766
Practice Address - Street 1:3533 S ALAMEDA ST
Practice Address - Street 2:2ND FLOOR HEALTH CENTER, SUITE H260
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1721
Practice Address - Country:US
Practice Address - Phone:361-694-1550
Practice Address - Fax:361-808-2766
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM30482084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry