Provider Demographics
NPI:1386774933
Name:ESHNA, INC.
Entity type:Organization
Organization Name:ESHNA, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AMAN
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:254-694-4428
Mailing Address - Street 1:PO BOX 1629
Mailing Address - Street 2:
Mailing Address - City:WHITNEY
Mailing Address - State:TX
Mailing Address - Zip Code:76692-1629
Mailing Address - Country:US
Mailing Address - Phone:254-694-4428
Mailing Address - Fax:254-694-0280
Practice Address - Street 1:200 N SAN JACINTO ST
Practice Address - Street 2:
Practice Address - City:WHITNEY
Practice Address - State:TX
Practice Address - Zip Code:76692-2388
Practice Address - Country:US
Practice Address - Phone:254-694-4428
Practice Address - Fax:254-694-0280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008210261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00805ZMedicare ID - Type UnspecifiedRURAL HEALTH CLINIC
TX450270Medicare ID - Type Unspecified