Individual provider Active NPI

Tiesha Nicole Deloach, APRN

  • Family Nurse Practitioner
  • Kingwood, TX
National Provider Identifier
1790360568
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1071101 Issued in TX
Practice address
4435 Kingwood Dr
Kingwood, TX 77339-3701
Phone
(281) 783-8162
NPI assigned
Mar 13, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1071101 TX Primary

Addresses

Primary practice location

4435 Kingwood Dr
Kingwood, TX 77339-3701

Mailing address

5718 Westheimer Rd Ste 1800
Houston, TX 77057-5773

Other practice location 1

19108 Bajo Dr
Edmond, OK 73012-2654
Phone (405) 204-1702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220919000308 TX Practitioner - Nurse Practitioner 9032594619 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors Express of the Beaumont Area PAGroup PAC ID 5698816882, 211 clinicians

Practice addresses (Care Compare)

3195 Dowlen Rd
Suite 105
Beaumont, TX 77706-7272
Phone (409) 860-1888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southlake Doctors Express, PA PSC Current Accepting new patients
Next Level MV LLC CurrentSince Nov 15, 2022 Accepting new patients
Doctors Express of the Beaumont Area PA CurrentSince Dec 31, 2023 Accepting new patients
Nluc PLLC CurrentSince Nov 15, 2022 Accepting new patients
Next Level MV LLC CurrentSince Nov 15, 2022 Accepting new patients
Nluc PLLC CurrentSince Nov 15, 2022 Accepting new patients
Doctors Express of the Temple Area, PA Past Accepting new patients
Larouge Personal Home Care, Inc. PastSince Jul 1, 2021 Accepting new patients

Locations

596 E Stacy Rd
Allen, TX 75002
Phone (469) 898-0199

6600 S Mopac Expy
Ste 2180
Austin, TX 78749
Phone (512) 522-3010

7710 Garth Rd
Ste A
Baytown, TX 77521

8831 N Highway 146
Baytown, TX 77523
Phone (281) 533-8354

3195 Dowlen Rd
Ste 105
Beaumont, TX 77706
Phone (409) 860-1888

1246 N FM 3083 Rd W
Ste B
Conroe, TX 77304

6340 N Eldridge Pkwy
Ste O
Houston, TX 77041
Phone (346) 385-9181

5718 Westheimer Rd
Ste 1800
Houston, TX 77057

9455 N Sam Houston Pkwy E
Ste 700
Humble, TX 77396
Phone 2813356111 ext. 1

6445 FM 1463 Rd
Ste 230
Katy, TX 77494
Phone (281) 990-6890

4435 Kingwood Dr
Kingwood, TX 77339
Phone (281) 360-7711

8850 Spencer Hwy
La Porte, TX 77571
Phone (281) 946-9980

1921 W League City Pkwy
Ste 130
League City, TX 77573
Phone (281) 937-2590

8325 Broadway St
Ste 220
Pearland, TX 77581
Phone (281) 873-8162

4724 Lakeview Pkwy
Ste 300
Rowlett, TX 75088
Phone (469) 947-6240

2315 E Southlake Blvd
Ste 110
Southlake, TX 76092
Phone (817) 488-9922

5211 FM 2920 Rd
Ste 101
Spring, TX 77388

16312 Southwest Fwy
Ste 18
Sugar Land, TX 77479

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1615593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1790360568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5718 WESTHEIMER RD STE 1800",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770575773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4435 KINGWOOD DR",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773393701",
            "telephone_number": "281-783-8162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19108 Bajo Dr",
            "address_purpose": "LOCATION",
            "city": "Edmond",
            "state": "OK",
            "postal_code": "730122654",
            "country_code": "US",
            "telephone_number": "405-204-1702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELOACH",
        "first_name": "TIESHA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-13",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1071101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, TX

Sources for this page

Verify at the official NPI Registry.