Individual
QUANTAE THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1910 PACIFIC AVE # 12015, DALLAS, TX 75201-4529
(214) 727-5791
Mailing address
623 SIRIUS DR, WAXAHACHIE, TX 75165-2190
(214) 727-5791
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
—
TX
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1003125
TX
Other
Enumeration date
02/13/2019
Last updated
12/06/2022
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