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General NPI Number Information
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NPI Number | 1558008110
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Entity Type | Individual
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Provider Name | SHONDRA CALDWELL
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Gender | Female
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Dates
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Enumeration Date | 05/16/2022
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 12280 BROADWAY ST STE 3109
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City | PEARLAND
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State | TX
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Zip | 77584-7868
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Country | US
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Telephone | 346-739-3840
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Fax |
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Provider Business Mailing Address
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Address Line | 2703 CRYSTAL FALLS CT
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City | PEARLAND
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State | TX
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Zip | 77584-2521
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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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 | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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