MEDICARE: TREVOR SHAWBER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant

General Provider Information

NPI Number	:	1285432997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TREVOR SHAWBER

Provider Business Mailing Address
First Line	:	13149 RICH LN
Second Line	:
City	:	PROVIDENCE VILLAGE
State	:	TX
Zip	:	76227-5395
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6521 COLLIN MCKINNEY PKWY
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-2726
Country	:	US
Telephone Number	:	419-631-5100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2025
Last Update Date	:	03/06/2025

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Directions to “ TREVOR SHAWBER ” Practice Location

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