Provider Demographics
NPI:1952077885
Name:KEETCH, VALENCIA MERIA (PC)
Entity Type:Individual
Prefix:MRS
First Name:VALENCIA
Middle Name:MERIA
Last Name:KEETCH
Suffix:
Gender:F
Credentials:PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17030 NANES DR STE 109
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2500
Mailing Address - Country:US
Mailing Address - Phone:713-535-9727
Mailing Address - Fax:
Practice Address - Street 1:17030 NANES DR STE 109
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2500
Practice Address - Country:US
Practice Address - Phone:713-535-9727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-19
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care