Provider Demographics
NPI:1770231094
Name:SPARKS, LAKQUISE
Entity Type:Individual
Prefix:MS
First Name:LAKQUISE
Middle Name:
Last Name:SPARKS
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 1:811 E YELLOWJACKET LN STE 107
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-4819
Mailing Address - Country:US
Mailing Address - Phone:214-908-2016
Mailing Address - Fax:
Practice Address - Street 1:811 E YELLOWJACKET LN STE 107
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-4819
Practice Address - Country:US
Practice Address - Phone:214-908-2016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist