Provider Demographics
NPI:1164110854
Name:BRISCOE, SHEMEANNA
Entity Type:Individual
Prefix:
First Name:SHEMEANNA
Middle Name:
Last Name:BRISCOE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18482 KUYKENDAHL RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-8123
Mailing Address - Country:US
Mailing Address - Phone:346-430-1282
Mailing Address - Fax:
Practice Address - Street 1:6111 CYPRESS CREEK PKWY STE 102
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-4108
Practice Address - Country:US
Practice Address - Phone:346-430-1282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory