Provider Demographics
NPI:1821064668
Name:BIRD, QUAYLA MARIE (TECHNICIAN)
Entity Type:Individual
Prefix:MRS
First Name:QUAYLA
Middle Name:MARIE
Last Name:BIRD
Suffix:
Gender:F
Credentials:TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COMDT US COAST GUARD
Mailing Address - Street 2:2100 2ND ST SW SUITE 5314
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20593-0001
Mailing Address - Country:US
Mailing Address - Phone:281-929-2421
Mailing Address - Fax:
Practice Address - Street 1:695 PINELOCH DR
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-1855
Practice Address - Country:US
Practice Address - Phone:619-957-4809
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other