Provider Demographics
NPI:1891294765
Name:LAPREAD-SHOULDERS, EVETTA (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:EVETTA
Middle Name:
Last Name:LAPREAD-SHOULDERS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11152 WESTHEIMER RD # 1017
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-3208
Mailing Address - Country:US
Mailing Address - Phone:281-561-5043
Mailing Address - Fax:
Practice Address - Street 1:6926 POUTER DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-3527
Practice Address - Country:US
Practice Address - Phone:281-561-5043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-06
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX461295163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX461295OtherNURSING LICENSE