Healthcare Provider Details

I. General information

NPI: 1245195494
Provider Name (Legal Business Name): KENISHA NEAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5423 BACHER ST UNIT A
HOUSTON TX
77028-5559
US

IV. Provider business mailing address

5423 BACHER ST UNIT A
HOUSTON TX
77028-5559
US

V. Phone/Fax

Practice location:
  • Phone: 757-979-0941
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: