Provider Demographics
NPI:1205373271
Name:TEXAS UNITED ENERGY WORKERS HEALTHCARE LLC
Entity Type:Organization
Organization Name:TEXAS UNITED ENERGY WORKERS HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUMWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-459-4407
Mailing Address - Street 1:614 E MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:WY
Mailing Address - Zip Code:82501-4460
Mailing Address - Country:US
Mailing Address - Phone:435-459-4407
Mailing Address - Fax:
Practice Address - Street 1:6666 W AMARILLO BLVD
Practice Address - Street 2:#17
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1756
Practice Address - Country:US
Practice Address - Phone:435-459-4407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-27
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health