Provider Demographics
NPI:1427769488
Name:BRIGGINS, LAQUEL JANEY
Entity type:Individual
Prefix:
First Name:LAQUEL
Middle Name:JANEY
Last Name:BRIGGINS
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 1:2044 SHADOW RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-4626
Mailing Address - Country:US
Mailing Address - Phone:347-757-8269
Mailing Address - Fax:
Practice Address - Street 1:9895 ALAMEDA AVE
Practice Address - Street 2:
Practice Address - City:SOCORRO
Practice Address - State:TX
Practice Address - Zip Code:79927-2956
Practice Address - Country:US
Practice Address - Phone:347-757-8269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management