Provider Demographics
NPI:1174184543
Name:MATTHEWS, KESCHIA (EDD)
Entity Type:Individual
Prefix:DR
First Name:KESCHIA
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2118 BEACON LIGHT LN
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-7089
Mailing Address - Country:US
Mailing Address - Phone:281-721-4555
Mailing Address - Fax:281-944-5685
Practice Address - Street 1:2118 BEACON LIGHT LN
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-7089
Practice Address - Country:US
Practice Address - Phone:281-721-4555
Practice Address - Fax:281-944-5685
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty