Provider Demographics
NPI:1821247834
Name:STANKUS, TAMMY LEE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:LEE
Last Name:STANKUS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4863 FARM ROAD 905
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75462-8871
Mailing Address - Country:US
Mailing Address - Phone:903-784-1860
Mailing Address - Fax:
Practice Address - Street 1:4863 FARM ROAD 905
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75462-8871
Practice Address - Country:US
Practice Address - Phone:903-784-1860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102388225X00000X
OKOT492225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist