Provider Demographics
NPI:1972389468
Name:WALKER, TREMETRIE VIRGINIA
Entity type:Individual
Prefix:
First Name:TREMETRIE
Middle Name:VIRGINIA
Last Name:WALKER
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 1:114 N LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LAKE DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75065-3462
Mailing Address - Country:US
Mailing Address - Phone:682-365-3763
Mailing Address - Fax:
Practice Address - Street 1:405 STATE HIGHWAY 121 BYP STE 250
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-4183
Practice Address - Country:US
Practice Address - Phone:682-365-3763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-31
Last Update Date:2023-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No251S00000XAgenciesCommunity/Behavioral Health