MEDICARE: SHIELDS CASE MANAGEMENT AND IMMUNIZATION SERVICES 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
1	251K00000X	Public Health or Welfare Agency

General Provider Information

NPI Number	:	1316386295
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHIELDS CASE MANAGEMENT AND IMMUNIZATION SERVICES INC

Provider Business Mailing Address
First Line	:	6260 WESTPARK DR SUITE 277
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057
Country	:	US
Telephone Number	:	832-412-1213
Fax Number	:

Provider Business Practice Location Address
First Line	:	6260 WESTPARK DR STE 277
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-7353
Country	:	US
Telephone Number	:	832-412-1213
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	CINDY UGBAJA
Credential	:
Telephone Number	:	832-412-1213

Provider Enumeration Date	:	06/24/2013
Last Update Date	:	06/24/2013

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