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NPI Code Detail

MEDICARE: SHALOM MOBILE HEALTH MINISTRY

MEDICARE: SHALOM MOBILE HEALTH MINISTRY
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
1363AM0700XMedical Physician AssistantPA01477TX

General Provider Information

NPI Number : 1134437189
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHALOM MOBILE HEALTH MINISTRY
Provider Business Mailing Address
First Line : 8121 BROADWAY ST
Second Line : STE. 103
City : HOUSTON
State : TX
Zip : 77061-1340
Country : US
Telephone Number : 713-900-2750
Fax Number : 713-900-2751
Provider Business Practice Location Address
First Line : 8121 BROADWAY ST
Second Line : STE. 103
City : HOUSTON
State : TX
Zip : 77061-1340
Country : US
Telephone Number : 713-900-2750
Fax Number : 713-900-2751
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MRS. MONICA KING
Credential :
Telephone Number : 713-900-2750
Provider Enumeration Date : 09/23/2010
Last Update Date : 03/07/2012

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Directions to “SHALOM MOBILE HEALTH MINISTRY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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