Provider Demographics
NPI:1124192679
Name:SHAE-RUN INC.
Entity Type:Organization
Organization Name:SHAE-RUN INC.
Other - Org Name:HEALTH INNOVATIONS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RON
Authorized Official - Middle Name:W
Authorized Official - Last Name:WESTBROOK
Authorized Official - Suffix:
Authorized Official - Credentials:DC, ND
Authorized Official - Phone:940-627-7811
Mailing Address - Street 1:1700 W BUSINESS 380
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-3232
Mailing Address - Country:US
Mailing Address - Phone:940-627-7811
Mailing Address - Fax:
Practice Address - Street 1:1700 W BUSINESS 380
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3232
Practice Address - Country:US
Practice Address - Phone:940-627-7811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF002746261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1841296704OtherDR. WESTBROOK'S NPI
TX450283Medicare UPIN
TX00307ZMedicare PIN