Provider Demographics
NPI:1902620321
Name:KEITH, SHEMEKA
Entity type:Individual
Prefix:
First Name:SHEMEKA
Middle Name:
Last Name:KEITH
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 1:2800 S PLEASANT VALLEY RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-4852
Mailing Address - Country:US
Mailing Address - Phone:512-435-7555
Mailing Address - Fax:
Practice Address - Street 1:2800 S PLEASANT VALLEY RD UNIT A
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78741-4852
Practice Address - Country:US
Practice Address - Phone:512-435-7555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health