Provider Demographics
NPI:1538477088
Name:TANISHA A TOASTON DO PA
Entity type:Organization
Organization Name:TANISHA A TOASTON DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-284-9850
Mailing Address - Street 1:PO BOX 631309
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-0017
Mailing Address - Country:US
Mailing Address - Phone:817-284-9850
Mailing Address - Fax:949-955-7361
Practice Address - Street 1:2304 HIGHWAY 121
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-5985
Practice Address - Country:US
Practice Address - Phone:817-284-9850
Practice Address - Fax:817-284-9859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-17
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM76922081P0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0078TYOtherBCBS
TX0078TYOtherBCBS
TXTXB115590Medicare PIN