Provider Demographics
NPI:1427805407
Name:STRONG, KEONTE A
Entity type:Individual
Prefix:
First Name:KEONTE
Middle Name:A
Last Name:STRONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13106 SUMMIT HARVEST LN
Mailing Address - Street 2:
Mailing Address - City:ROSHARON
Mailing Address - State:TX
Mailing Address - Zip Code:77583-2679
Mailing Address - Country:US
Mailing Address - Phone:409-238-7661
Mailing Address - Fax:
Practice Address - Street 1:13106 SUMMIT HARVEST LN
Practice Address - Street 2:
Practice Address - City:ROSHARON
Practice Address - State:TX
Practice Address - Zip Code:77583-2679
Practice Address - Country:US
Practice Address - Phone:409-238-7661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator