Provider Demographics
NPI:1326464207
Name:ARCENEAUX, SHAYLA
Entity Type:Individual
Prefix:
First Name:SHAYLA
Middle Name:
Last Name:ARCENEAUX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHAYLA
Other - Middle Name:
Other - Last Name:ARCENEAUX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA
Mailing Address - Street 1:18980 N MEMORIAL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4498
Mailing Address - Country:US
Mailing Address - Phone:281-707-6400
Mailing Address - Fax:281-584-6432
Practice Address - Street 1:18980 N MEMORIAL DR STE 200
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4498
Practice Address - Country:US
Practice Address - Phone:281-707-6400
Practice Address - Fax:281-584-6432
Is Sole Proprietor?:No
Enumeration Date:2014-03-14
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA08889363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX348067YLUVMedicare PIN