MEDICARE: SHANQUERIA WIGGINS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	2187653	TX

General Provider Information

NPI Number	:	1932036266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANQUERIA WIGGINS

Provider Business Mailing Address
First Line	:	707 SAULNIER ST APT 1525
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019-1438
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	707 SAULNIER ST APT 1525
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019-1438
Country	:	US
Telephone Number	:	850-566-3191
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2026
Last Update Date	:	05/08/2026

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Directions to “ SHANQUERIA WIGGINS ” Practice Location

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