Provider Demographics
NPI:1245400431
Name:SHAREIKA D TELLISON
Entity Type:Organization
Organization Name:SHAREIKA D TELLISON
Other - Org Name:HOUSTON'S BEST MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAREIKA
Authorized Official - Middle Name:DONYE
Authorized Official - Last Name:TELLISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-779-0125
Mailing Address - Street 1:10039 BISSONNET ST
Mailing Address - Street 2:209
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-7854
Mailing Address - Country:US
Mailing Address - Phone:713-779-0125
Mailing Address - Fax:713-779-1668
Practice Address - Street 1:10039 BISSONNET ST
Practice Address - Street 2:209
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-7854
Practice Address - Country:US
Practice Address - Phone:713-779-0125
Practice Address - Fax:713-779-1668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0096128332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX195691403Medicaid
TX6081280001Medicare NSC