Provider Demographics
NPI:1053802165
Name:MEEKS, AISHA AKSOUA (IFMCP)
Entity type:Individual
Prefix:
First Name:AISHA
Middle Name:AKSOUA
Last Name:MEEKS
Suffix:
Gender:F
Credentials:IFMCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2506 OVILLA RD STE B
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-4009
Mailing Address - Country:US
Mailing Address - Phone:469-820-9331
Mailing Address - Fax:
Practice Address - Street 1:2506 OVILLA RD STE B
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154-4009
Practice Address - Country:US
Practice Address - Phone:469-820-9331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist