Provider Demographics
NPI:1295120731
Name:NNAMANI, TAMMY (MS)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:NNAMANI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 N STEMMONS FWY
Mailing Address - Street 2:SUITE 6045
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-3832
Mailing Address - Country:US
Mailing Address - Phone:214-879-1964
Mailing Address - Fax:214-879-1968
Practice Address - Street 1:8500 N STEMMONS FWY
Practice Address - Street 2:SUITE 6045
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-3832
Practice Address - Country:US
Practice Address - Phone:214-879-1964
Practice Address - Fax:214-879-1968
Is Sole Proprietor?:No
Enumeration Date:2015-04-01
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172A00000X, 171W00000X
TX171M00000X, 225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
No172A00000XOther Service ProvidersDriver
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQMP000004721735OtherMCO