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Contact Information

SHEPHERD RURAL HEALTH CLINIC PA
11 WOODLAND PARK DRIVE
SHEPHERD, TX77371
 Phone: 936-628-3343
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for SHEPHERD RURAL HEALTH CLINIC PA · (Female)

NPI Number 1376629212
Status Active
Credentials
Entity Individual
Enumeration date 10/31/2006
Last updated 08/30/2010 - About 16 years ago
Sole proprietor 1 Not specified
Identifiers
  • TX License # F4703
  • TX Medicaid 130767003
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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