Provider Demographics
NPI:1992377295
Name:PRICE, SHAQUALA LECHELLE (LPTA)
Entity Type:Individual
Prefix:MISS
First Name:SHAQUALA
Middle Name:LECHELLE
Last Name:PRICE
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:MISS
Other - First Name:SHAQUALA
Other - Middle Name:LECHELLE
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPTA
Mailing Address - Street 1:764 INTERNATIONAL BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-3585
Mailing Address - Country:US
Mailing Address - Phone:346-456-3764
Mailing Address - Fax:
Practice Address - Street 1:2277 CHESTNUT RIDGE DRIVE
Practice Address - Street 2:
Practice Address - City:KINGSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339
Practice Address - Country:US
Practice Address - Phone:570-412-5256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2155619208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation