Provider Demographics
NPI:1043081706
Name:MAYSHACK, ARTHUR L
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:L
Last Name:MAYSHACK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:689 FOREST BEND LN
Mailing Address - Street 2:
Mailing Address - City:LA MARQUE
Mailing Address - State:TX
Mailing Address - Zip Code:77568-1599
Mailing Address - Country:US
Mailing Address - Phone:832-367-5156
Mailing Address - Fax:
Practice Address - Street 1:689 FOREST BEND LN
Practice Address - Street 2:
Practice Address - City:LA MARQUE
Practice Address - State:TX
Practice Address - Zip Code:77568-1599
Practice Address - Country:US
Practice Address - Phone:832-367-5156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376G00000XNursing Service Related ProvidersNursing Home AdministratorGroup - Single Specialty