Provider Demographics
NPI:1255112348
Name:KEMUEL, AVAIRE
Entity type:Individual
Prefix:
First Name:AVAIRE
Middle Name:
Last Name:KEMUEL
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 1:18319 GLEN SHEE DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-4353
Mailing Address - Country:US
Mailing Address - Phone:512-968-1981
Mailing Address - Fax:737-338-8220
Practice Address - Street 1:18319 GLEN SHEE DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-4353
Practice Address - Country:US
Practice Address - Phone:512-968-1981
Practice Address - Fax:737-338-8220
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle