Provider Demographics
NPI:1871818252
Name:SHIELD TEXAS HEALTHCARE INC
Entity Type:Organization
Organization Name:SHIELD TEXAS HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF CUSTOMER EXPERIENCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-294-4222
Mailing Address - Street 1:27911 FRANKLIN PKWY
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-4110
Mailing Address - Country:US
Mailing Address - Phone:661-294-4200
Mailing Address - Fax:661-294-1042
Practice Address - Street 1:9901 BROADWAY ST STE 113
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-4916
Practice Address - Country:US
Practice Address - Phone:800-495-0999
Practice Address - Fax:210-375-0009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-29
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
0388130003Medicare NSC