Provider Demographics
NPI:1992345862
Name:FOSTER, RONEISHA LAQUECE (LICENSED PAS)
Entity type:Individual
Prefix:
First Name:RONEISHA
Middle Name:LAQUECE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:LICENSED PAS
Other - Prefix:
Other - First Name:RONEISHA
Other - Middle Name:L
Other - Last Name:RUTHERFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:618 1ST ST E STE C
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4639
Mailing Address - Country:US
Mailing Address - Phone:281-883-4921
Mailing Address - Fax:281-883-4916
Practice Address - Street 1:618 1ST ST E STE C
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4639
Practice Address - Country:US
Practice Address - Phone:281-883-4921
Practice Address - Fax:281-883-4916
Is Sole Proprietor?:No
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX019383372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider