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General NPI Number Information
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NPI Number | 1225497845
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Entity Type | Organization
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Legal Business Name | SHEBA MANAGEMENT LLC
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Dates
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Enumeration Date | 02/11/2016
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Last Update Date | 02/11/2016
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Provider Practice Location Address
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Address Line | 1710 CLAYTONS COVE CT
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City | SPRING
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State | TX
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Zip | 77386-2950
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Country | US
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Telephone | 281-815-0932
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Fax |
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Provider Business Mailing Address
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Address Line | 1710 CLAYTONS COVE CT
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City | SPRING
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State | TX
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Zip | 77386-2950
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. BETH JEFFERSON
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Credential |
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Telephone | 281-815-0932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 126800000X
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Taxonomy Name | Dental Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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