Provider Demographics
NPI:1689397358
Name:TAYLOR, TANQUILLA
Entity Type:Individual
Prefix:MS
First Name:TANQUILLA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:TANQUILLA
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:QT ZONE ENTERPRISES
Mailing Address - Street 1:7444 CANDLERIDGE CIR APT 1516
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76133-6593
Mailing Address - Country:US
Mailing Address - Phone:682-326-8538
Mailing Address - Fax:
Practice Address - Street 1:7444 CANDLERIDGE CIR APT 1516
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76133-6593
Practice Address - Country:US
Practice Address - Phone:682-326-8538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle