Provider Demographics
NPI:1073975538
Name:MCBRIDE, KAMEESHA (HAIR LOSS SPECIALIST)
Entity Type:Individual
Prefix:
First Name:KAMEESHA
Middle Name:
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:HAIR LOSS SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 442
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78691-0442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2000 S IH 35 STE F1
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-6934
Practice Address - Country:US
Practice Address - Phone:512-758-4102
Practice Address - Fax:512-758-4102
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist