Provider Demographics
NPI:1841400751
Name:TOASTON, TANISHA A (DO)
Entity Type:Individual
Prefix:DR
First Name:TANISHA
Middle Name:A
Last Name:TOASTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 631309
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-0017
Mailing Address - Country:US
Mailing Address - Phone:214-876-5506
Mailing Address - Fax:
Practice Address - Street 1:2304 HIGHWAY 121
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-5985
Practice Address - Country:US
Practice Address - Phone:817-684-2000
Practice Address - Fax:817-358-8710
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM76922081P0004X, 2081P0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0029RROtherBCBS
TX8CP032OtherBCBS
NCNCD458AMedicare PIN
TX8CP032OtherBCBS
TXTXB115593Medicare PIN
TXTXB115591Medicare PIN
TXTXB115593Medicare PIN
TXTXB115591Medicare PIN