Provider Demographics
NPI:1831841758
Name:GROOMES, SHENIQUE
Entity type:Individual
Prefix:
First Name:SHENIQUE
Middle Name:
Last Name:GROOMES
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 1:15928 DORRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75036-7139
Mailing Address - Country:US
Mailing Address - Phone:469-768-1419
Mailing Address - Fax:
Practice Address - Street 1:15928 DORRINGTON DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75036-7139
Practice Address - Country:US
Practice Address - Phone:469-768-1419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist