MEDICARE: KENISHA NEAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	385H00000X	Respite Care
2	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1245195494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENISHA NEAL

Provider Business Mailing Address
First Line	:	5423 BACHER ST UNIT A
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77028-5559
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5423 BACHER ST UNIT A
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77028-5559
Country	:	US
Telephone Number	:	757-979-0941
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2025
Last Update Date	:	12/19/2025

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Directions to “ KENISHA NEAL ” Practice Location

Language	Start Address	Practice Location

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