Provider Demographics
NPI:1306158100
Name:HOOKS, SHOMONA RENEE (OTR)
Entity type:Individual
Prefix:
First Name:SHOMONA
Middle Name:RENEE
Last Name:HOOKS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5704 DEERFOOT TRL
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76131-1730
Mailing Address - Country:US
Mailing Address - Phone:816-522-9508
Mailing Address - Fax:
Practice Address - Street 1:5704 DEERFOOT TRL
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76131-1730
Practice Address - Country:US
Practice Address - Phone:816-522-9508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113667174400000X
MD06224174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist