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General NPI Number Information
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NPI Number | 1245588706
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Entity Type | Organization
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Legal Business Name | SHAW/LOVALL HEALTHCARE LLC
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 08/15/2012
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Provider Practice Location Address
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Address Line | 12763 CAPRICORN ST STE 500
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City | STAFFORD
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State | TX
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Zip | 77477-3989
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Country | US
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Telephone | 281-980-3328
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Fax |
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Provider Business Mailing Address
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Address Line | 12763 CAPRICORN ST STE 500
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City | STAFFORD
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State | TX
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Zip | 77477-3989
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Country | US
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Telephone | 281-980-3328
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KEEBLE LOVALL
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Credential |
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Telephone | 281-980-3328
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | TX14029
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License Number State | TX
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