Provider Demographics
NPI:1215627898
Name:GREEN, MEYOSHI DEANNA
Entity type:Individual
Prefix:
First Name:MEYOSHI
Middle Name:DEANNA
Last Name:GREEN
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 1:12210 MEADOW PARK CT
Mailing Address - Street 2:
Mailing Address - City:MEADOWS PLACE
Mailing Address - State:TX
Mailing Address - Zip Code:77477-2255
Mailing Address - Country:US
Mailing Address - Phone:832-739-7685
Mailing Address - Fax:
Practice Address - Street 1:12210 MEADOW PARK CT
Practice Address - Street 2:
Practice Address - City:MEADOWS PLACE
Practice Address - State:TX
Practice Address - Zip Code:77477-2255
Practice Address - Country:US
Practice Address - Phone:832-739-7685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No374U00000XNursing Service Related ProvidersHome Health Aide