Provider Demographics
NPI:1184932519
Name:SHAW/LOVALL HEALTHCARE LLC
Entity type:Organization
Organization Name:SHAW/LOVALL HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMIKA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-980-3328
Mailing Address - Street 1:12763 CAPRICORN ST
Mailing Address - Street 2:500
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-3980
Mailing Address - Country:US
Mailing Address - Phone:281-980-3328
Mailing Address - Fax:281-676-5089
Practice Address - Street 1:12763 CAPRICORN ST
Practice Address - Street 2:500
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3980
Practice Address - Country:US
Practice Address - Phone:281-980-3328
Practice Address - Fax:281-676-5089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-20
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health