Individual
MS. LA TAVIA DOMONIQUE CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10700 FUQUA ST APT 190, HOUSTON, TX 77089-2443
(281) 786-9809
(346) 229-4101
Mailing address
10700 FUQUA ST APT 190, HOUSTON, TX 77089-2443
(281) 786-9809
(346) 229-4101
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
474361671
—
TX
05
—
474753724
—
TX
Enumeration date
08/15/2017
Last updated
06/11/2019
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