Individual
MARQUETTE SHANTEE THOMASRUFUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 E PARKERVILLE RD STE A8, DESOTO, TX 75115-6420
(469) 747-3155
(800) 517-4729
Mailing address
1301 E PARKERVILLE RD STE A8, DESOTO, TX 75115-6420
(469) 747-3155
(800) 517-4729
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
—
171W00000X
Contractor
—
—
172A00000X
Driver
—
—
172V00000X
Community Health Worker
—
—
246QL0900X
Laboratory Management Specialist/Technologist
—
—
246RP1900X
Phlebotomy Technician
—
—
247200000X
Other Technician
Primary
115570
TX
374U00000X
Home Health Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45D2247456
CLIA LABORATORY
TX
Enumeration date
01/31/2022
Last updated
01/31/2022
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