Provider Demographics
NPI:1326473372
Name:SHAUN'S RESPIRATORY SOLUTIONS, LLP
Entity Type:Organization
Organization Name:SHAUN'S RESPIRATORY SOLUTIONS, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAUN
Authorized Official - Middle Name:T
Authorized Official - Last Name:DIERKSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-794-4386
Mailing Address - Street 1:6500 SUMMERHILL RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-1721
Mailing Address - Country:US
Mailing Address - Phone:903-793-6464
Mailing Address - Fax:903-793-6405
Practice Address - Street 1:1006 WESTLAWN DR
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75501-4069
Practice Address - Country:US
Practice Address - Phone:903-794-4386
Practice Address - Fax:903-793-4389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-10
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health