Provider Demographics
NPI:1134755150
Name:MCHARGH, SHUDYLYN
Entity type:Individual
Prefix:
First Name:SHUDYLYN
Middle Name:
Last Name:MCHARGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7205 ALMEDA RD UNIT 301221
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77230-1312
Mailing Address - Country:US
Mailing Address - Phone:713-819-6155
Mailing Address - Fax:
Practice Address - Street 1:2310 MAIN ST APT 204
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-9154
Practice Address - Country:US
Practice Address - Phone:713-819-6155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-21
Last Update Date:2020-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95082218163WC0200X
TX951878163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine