Provider Demographics
NPI:1225374663
Name:HEALTHSHIELD, INC.
Entity Type:Organization
Organization Name:HEALTHSHIELD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:254-776-3600
Mailing Address - Street 1:P.O. BOX 23452
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76702
Mailing Address - Country:US
Mailing Address - Phone:254-776-3600
Mailing Address - Fax:254-776-3602
Practice Address - Street 1:611 W. HWY. 6
Practice Address - Street 2:SUITE # 113
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-7545
Practice Address - Country:US
Practice Address - Phone:254-776-3600
Practice Address - Fax:254-776-3602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-12
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9045111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty