Provider Demographics
NPI:1225336860
Name:SHJD EVOLUTION MEDICAL SOLUTIONS LLC
Entity Type:Organization
Organization Name:SHJD EVOLUTION MEDICAL SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEBASTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-754-7692
Mailing Address - Street 1:9659 N SAM HOUSTON PKWY E
Mailing Address - Street 2:SUITE 150 # 234
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-1529
Mailing Address - Country:US
Mailing Address - Phone:832-754-7692
Mailing Address - Fax:832-442-5881
Practice Address - Street 1:9659 N SAM HOUSTON PKWY E
Practice Address - Street 2:SUITE 150 # 234
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-1529
Practice Address - Country:US
Practice Address - Phone:832-754-7692
Practice Address - Fax:832-442-5881
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHJD EVOLUTION MEDICAL SOLUTIONS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-07
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies