Shield Medical Supplies, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

0013124 Issued in TX

Legal business name

SHIELD MEDICAL SUPPLIES, INC

Practice address

405 Rusk St
Newton, TX 75966-3625

Phone

(409) 379-4695

Fax

(409) 379-5367

NPI assigned

May 29, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Robert E. Davis

Title

Director

Phone

(409) 379-9032

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639126154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 RUSK ST",
            "city": "NEWTON",
            "state": "TX",
            "postal_code": "759663625",
            "telephone_number": "409-379-4695",
            "fax_number": "409-379-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 RUSK ST",
            "city": "NEWTON",
            "state": "TX",
            "postal_code": "759663625",
            "telephone_number": "409-379-4695",
            "fax_number": "409-379-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIELD MEDICAL SUPPLIES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "409-379-9032"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "0013124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS B/S OF TEXAS",
            "identifier": "532084",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007563652",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Newton, TX
• Providers in Newton, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.