Provider Demographics
NPI:1861360869
Name:READ, SHAQUILE
Entity type:Individual
Prefix:
First Name:SHAQUILE
Middle Name:
Last Name:READ
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 1:745 SOAR SKY WAY
Mailing Address - Street 2:
Mailing Address - City:LAVON
Mailing Address - State:TX
Mailing Address - Zip Code:75166-1298
Mailing Address - Country:US
Mailing Address - Phone:773-964-7266
Mailing Address - Fax:
Practice Address - Street 1:789 JUSTIN RD
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-4840
Practice Address - Country:US
Practice Address - Phone:972-771-5731
Practice Address - Fax:972-771-5786
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-29
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX217240224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty