Provider Demographics
NPI:1891085197
Name:KEKEOCHA, CATHY
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:KEKEOCHA
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 1:1626 HAVELOCK DR
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77386
Mailing Address - Country:US
Mailing Address - Phone:832-326-2010
Mailing Address - Fax:888-566-4246
Practice Address - Street 1:5755 COLLEGE ST STE C
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707-3518
Practice Address - Country:US
Practice Address - Phone:832-326-2010
Practice Address - Fax:888-566-4246
Is Sole Proprietor?:No
Enumeration Date:2011-04-08
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45D2057150246RM2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory