Healthcare Provider Details

I. General information

NPI: 1184729675
Provider Name (Legal Business Name): TQC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 S MAIN ST
GRAPEVINE TX
76051-5306
US

IV. Provider business mailing address

2601 MILK RIVER XING
SOUTHLAKE TX
76092-3235
US

V. Phone/Fax

Practice location:
  • Phone: 817-310-6630
  • Fax: 817-310-6640
Mailing address:
  • Phone: 817-925-5764
  • Fax: 817-310-6640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateTX
# 6
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateTX

VIII. Authorized Official

Name: MR. JAY GASMIRE
Title or Position: OWNER
Credential:
Phone: 817-925-5764