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NPI Code Detail

MEDICARE: SHAE-RUN INC.

MEDICARE: SHAE-RUN INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/CenterF002746TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11841296704OTHERTXDR. WESTBROOK'S NPI

General Provider Information

NPI Number : 1124192679
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHAE-RUN INC.
Provider Business Mailing Address
First Line : 1700 W BUSINESS 380
Second Line :
City : DECATUR
State : TX
Zip : 76234-3232
Country : US
Telephone Number : 940-627-7811
Fax Number :
Provider Business Practice Location Address
First Line : 1700 W BUSINESS 380
Second Line :
City : DECATUR
State : TX
Zip : 76234-3232
Country : US
Telephone Number : 940-627-7811
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. RON W WESTBROOK
Credential : D.C., N.D.
Telephone Number : 940-627-7811
Provider Enumeration Date : 11/17/2006
Last Update Date : 07/28/2008

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Directions to “SHAE-RUN INC. ” Practice Location

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