MEDICARE: SHIELD TEXAS HEALTHCARE 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	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
2	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1871818252
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHIELD TEXAS HEALTHCARE INC

Provider Business Mailing Address
First Line	:	27911 FRANKLIN PKWY
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91355-4110
Country	:	US
Telephone Number	:	661-294-4200
Fax Number	:	661-294-1042

Provider Business Practice Location Address
First Line	:	9901 BROADWAY ST STE 113
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217-4916
Country	:	US
Telephone Number	:	800-495-0999
Fax Number	:	210-375-0009

Authorized Official
Title or Position	:	VP GENERAL MANAGER
Name	:	MIKE SUOR
Credential	:
Telephone Number	:	661-294-4200

Provider Enumeration Date	:	03/29/2010
Last Update Date	:	01/14/2025

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Directions to “SHIELD TEXAS HEALTHCARE INC ” Practice Location

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