Provider Demographics
NPI:1356594501
Name:MESHIOYE, SHOFELA
Entity type:Individual
Prefix:
First Name:SHOFELA
Middle Name:
Last Name:MESHIOYE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9900 WESTPARK DR STE 230
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-5286
Mailing Address - Country:US
Mailing Address - Phone:713-834-4303
Mailing Address - Fax:814-284-4303
Practice Address - Street 1:9900 WESTPARK DR STE 230
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-5286
Practice Address - Country:US
Practice Address - Phone:713-834-4303
Practice Address - Fax:814-284-4303
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-01
Last Update Date:2008-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0106066332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies