Provider Demographics
NPI:1588455083
Name:MAEBERRY, KENNASA (PHLEBOTOMIST)
Entity type:Individual
Prefix:
First Name:KENNASA
Middle Name:
Last Name:MAEBERRY
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 CYPRESS CREEK PKWY STE 450
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-5699
Mailing Address - Country:US
Mailing Address - Phone:713-366-1546
Mailing Address - Fax:
Practice Address - Street 1:8300 CYPRESS CREEK PKWY STE 450
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-5699
Practice Address - Country:US
Practice Address - Phone:713-366-1546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy