Provider Demographics
NPI:1629163845
Name:SHAWN COUSINS/MEDI HELP
Entity Type:Organization
Organization Name:SHAWN COUSINS/MEDI HELP
Other - Org Name:MEDI HELP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:COUSINS
Authorized Official - Suffix:
Authorized Official - Credentials:RVT
Authorized Official - Phone:281-778-0997
Mailing Address - Street 1:6140 HIGHWAY 6 STE 83
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-3802
Mailing Address - Country:US
Mailing Address - Phone:281-778-0997
Mailing Address - Fax:
Practice Address - Street 1:6140 HIGHWAY 6 STE 83
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-3802
Practice Address - Country:US
Practice Address - Phone:281-778-0997
Practice Address - Fax:281-778-7406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NOT APPLICABLE293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170085801Medicaid
TXH0000425DCOtherBLUE CROSS
FTVUC10Medicare PIN