Provider Demographics
NPI:1710871272
Name:TRANQUILICARE
Entity type:Organization
Organization Name:TRANQUILICARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:512-914-2865
Mailing Address - Street 1:1018 SPEEGLE ST
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:TX
Mailing Address - Zip Code:76574-2658
Mailing Address - Country:US
Mailing Address - Phone:512-914-2865
Mailing Address - Fax:512-549-7641
Practice Address - Street 1:3000 JOE DIMAGGIO BLVD STE 87
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-3992
Practice Address - Country:US
Practice Address - Phone:512-774-4685
Practice Address - Fax:512-549-7641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-06
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty