Provider Demographics
NPI:1952023541
Name:GOLDEN, SHUNATTA (PROVIDER MA)
Entity Type:Individual
Prefix:
First Name:SHUNATTA
Middle Name:
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:PROVIDER MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 RICHTER LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-6229
Mailing Address - Country:US
Mailing Address - Phone:832-557-0009
Mailing Address - Fax:
Practice Address - Street 1:511 RICHTER LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-6229
Practice Address - Country:US
Practice Address - Phone:832-557-0009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant