Provider Demographics
NPI:1841826013
Name:MAYHON, CHASITY SHAMEEL
Entity type:Individual
Prefix:
First Name:CHASITY
Middle Name:SHAMEEL
Last Name:MAYHON
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 1:11303 BEL AIR DR APT A
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-1432
Mailing Address - Country:US
Mailing Address - Phone:210-432-9461
Mailing Address - Fax:
Practice Address - Street 1:11303 BEL AIR DR APT A
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-1432
Practice Address - Country:US
Practice Address - Phone:210-432-9461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX981607163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse