Provider Demographics
NPI:1073839569
Name:SHIELDS HEALTHCARE SERVICES PLLC
Entity Type:Organization
Organization Name:SHIELDS HEALTHCARE SERVICES PLLC
Other - Org Name:SHIELDS HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:C
Authorized Official - Last Name:ETUOKWU
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MBA
Authorized Official - Phone:832-412-1213
Mailing Address - Street 1:6260 WESTPARK DR
Mailing Address - Street 2:SUITE # 277
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-7312
Mailing Address - Country:US
Mailing Address - Phone:832-412-1213
Mailing Address - Fax:888-859-5359
Practice Address - Street 1:6260 WESTPARK DR
Practice Address - Street 2:SUITE # 277
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-7312
Practice Address - Country:US
Practice Address - Phone:832-412-1213
Practice Address - Fax:888-859-5359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-09
Last Update Date:2022-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health