Provider Demographics
NPI:1154557924
Name:SHEPHERD PERSONAL CARE PROPERTIES LLC
Entity type:Organization
Organization Name:SHEPHERD PERSONAL CARE PROPERTIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PHEBA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPPACHAN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:832-767-5300
Mailing Address - Street 1:8323 SW FREEWAY
Mailing Address - Street 2:SUITE # 630
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1618
Mailing Address - Country:US
Mailing Address - Phone:832-767-5300
Mailing Address - Fax:832-767-5933
Practice Address - Street 1:8323 SW FWY
Practice Address - Street 2:SUITE # 630
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1615
Practice Address - Country:US
Practice Address - Phone:832-767-5300
Practice Address - Fax:832-767-5933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-06
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX219362501Medicaid
TX219362501Medicaid