Provider Demographics
NPI:1053497677
Name:RICHARD L SHORKEY EDUCATION & REHABILITATION CENTER
Entity Type:Organization
Organization Name:RICHARD L SHORKEY EDUCATION & REHABILITATION CENTER
Other - Org Name:SHORKEY CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:INSURANCE/BILLING ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:RE DEANA
Authorized Official - Middle Name:DEANA
Authorized Official - Last Name:SHAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-838-6568
Mailing Address - Street 1:855 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701
Mailing Address - Country:US
Mailing Address - Phone:409-838-6568
Mailing Address - Fax:409-838-1337
Practice Address - Street 1:855 S 8TH ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701
Practice Address - Country:US
Practice Address - Phone:409-838-6568
Practice Address - Fax:409-838-1337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0073BGOtherTX EXEC COUNCIL OCC & PT