Provider Demographics
NPI:1396496261
Name:BROWN, TAMIQUA A (LMT)
Entity type:Individual
Prefix:
First Name:TAMIQUA
Middle Name:A
Last Name:BROWN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:TAMIQUA
Other - Middle Name:A
Other - Last Name:QUIGLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5310 PAMPAS CT
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-1695
Mailing Address - Country:US
Mailing Address - Phone:817-800-0770
Mailing Address - Fax:
Practice Address - Street 1:117 S WATSON RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-2402
Practice Address - Country:US
Practice Address - Phone:682-593-5607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT129257225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXMT129257OtherMASSAGE THERAPIST