Provider Demographics
NPI:1487373601
Name:RISHER, SHATEREKIA ARSHAY (CAREGIVER)
Entity type:Individual
Prefix:MS
First Name:SHATEREKIA
Middle Name:ARSHAY
Last Name:RISHER
Suffix:
Gender:F
Credentials:CAREGIVER
Other - Prefix:MS
Other - First Name:SELESTINE
Other - Middle Name:RENEE
Other - Last Name:RISHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNA
Mailing Address - Street 1:4006 BLACK LOCUST DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77088-6824
Mailing Address - Country:US
Mailing Address - Phone:713-679-3265
Mailing Address - Fax:
Practice Address - Street 1:4006 BLACK LOCUST DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77088-6824
Practice Address - Country:US
Practice Address - Phone:713-679-3265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA0008120364376K00000X
TXNA171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXNAMedicaid