Provider Demographics
NPI:1245588706
Name:SHAW/LOVALL HEALTHCARE LLC
Entity Type:Organization
Organization Name:SHAW/LOVALL HEALTHCARE LLC
Other - Org Name:YOUR CHOICE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KEEBLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-980-3328
Mailing Address - Street 1:12763 CAPRICORN ST STE 500
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-3989
Mailing Address - Country:US
Mailing Address - Phone:281-980-3328
Mailing Address - Fax:
Practice Address - Street 1:12763 CAPRICORN ST STE 500
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3989
Practice Address - Country:US
Practice Address - Phone:281-980-3328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX14029251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based