Provider Demographics
NPI:1407396484
Name:TANKERSLEY, HELENA
Entity Type:Individual
Prefix:
First Name:HELENA
Middle Name:
Last Name:TANKERSLEY
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 1:600 PARK MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76087-5804
Mailing Address - Country:US
Mailing Address - Phone:817-771-5900
Mailing Address - Fax:
Practice Address - Street 1:600 PARK MEADOW DR
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76087-5804
Practice Address - Country:US
Practice Address - Phone:817-771-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-24
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other