Provider Demographics
NPI:1447351226
Name:SHAVER MEDICAL CLINIC P.A.
Entity type:Organization
Organization Name:SHAVER MEDICAL CLINIC P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-477-1973
Mailing Address - Street 1:520 SHAVER ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77506-2106
Mailing Address - Country:US
Mailing Address - Phone:713-477-1973
Mailing Address - Fax:713-477-1702
Practice Address - Street 1:520 SHAVER ST
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77506-2106
Practice Address - Country:US
Practice Address - Phone:713-477-1973
Practice Address - Fax:713-477-1702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE18989Medicare UPIN
TX00L06VMedicare PIN