Provider Demographics
NPI:1366247165
Name:MEEKS, SHEVON (CRANIAL PROSTHETIC)
Entity type:Individual
Prefix:
First Name:SHEVON
Middle Name:
Last Name:MEEKS
Suffix:
Gender:F
Credentials:CRANIAL PROSTHETIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12214 LAKEWOOD GLEN CT
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-2791
Mailing Address - Country:US
Mailing Address - Phone:951-525-7048
Mailing Address - Fax:
Practice Address - Street 1:12214 LAKEWOOD GLEN CT
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-2791
Practice Address - Country:US
Practice Address - Phone:951-525-7048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHLYWTE4DPH174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist