Organization
CUSTOM REHAB OF NORTH TEXAS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SANDRA SHIELDS CRTS (CEO)
(214) 744-3606
Entity
Organization
Contact information
Practice address
810 S SAINT PAUL ST, DALLAS, TX 75201-6216
(214) 744-3606
(214) 744-3609
Mailing address
810 S SAINT PAUL ST, DALLAS, TX 75201-6216
(214) 744-3606
(214) 744-3609
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0085543
TX
332BC3200X
Customized Equipment (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515568
BLUE CROSS
TX
Enumeration date
11/06/2006
Last updated
09/11/2025
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