Provider Demographics
NPI:1942845011
Name:AUGUSTINE, SHAMAAKA
Entity Type:Individual
Prefix:
First Name:SHAMAAKA
Middle Name:
Last Name:AUGUSTINE
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 1:1903 PRIMROSE CT
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2600
Mailing Address - Country:US
Mailing Address - Phone:214-997-3046
Mailing Address - Fax:214-260-1988
Practice Address - Street 1:1903 PRIMROSE CT
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2600
Practice Address - Country:US
Practice Address - Phone:214-997-3046
Practice Address - Fax:214-260-1988
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy