Tia Kingcannon is a Private Vehicle based in Dallas, TX. Tia Kingcannon practices in Dallas, TX. The NPI Number for Tia Kingcannon is 1841064342 and holds a License No. (Texas).
The current practice location address for Tia Kingcannon is 3662 W Camp Wisdom Rd, Dallas, TX and can be reached out via phone at 469-535-1965.
Location: 3662 W Camp Wisdom Rd, Dallas, TX, 75204-2581
Provider Profile Details
NPI Number
1841064342
Provider Name
Tia Kingcannon
Credential
Provider Entity Type
Individual
Gender
Female
Address
3662 W Camp Wisdom Rd, Dallas, TX, 75204-2581
Phone Number
469-535-1965
Fax Number
Provider Enumeration Date
11/14/2023
Last Update Date
03/10/2024
Provider Business Practice Location Address Details
Address
3662 W Camp Wisdom Rd
City
State
Zip
75237-2500
Phone Number
469-535-1965
Fax Number
Provider Business Mailing Address Details
Address
3662 W Camp Wisdom Rd
City
State
Zip
75237-2500
Phone Number
469-535-1965
Fax Number
Provider's Taxonomy Details 1
Type
Transportation Services
Classification
Private Vehicle
Speciality
-
Taxonomy
License No.
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Definition
An individual paid to provide non-emergency transportation using their privately owned/leased vehicle.
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