MEDICARE: DR. HEIDI CHAMBERLAIN SHEA M.D.

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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	K9417	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7355710	OTHER	TX	AETNA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578517926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HEIDI CHAMBERLAIN SHEA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 678118
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75267-8118
Country	:	US
Telephone Number	:	214-363-5535
Fax Number	:	214-368-2760

Provider Business Practice Location Address
First Line	:	1820 PRESTON PARK BLVD
Second Line	:	SUITE 1850
City	:	PLANO
State	:	TX
Zip	:	75093-3656
Country	:	US
Telephone Number	:	972-867-4658
Fax Number	:	972-867-8696

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

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	11/02/2007

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Directions to “ DR. HEIDI CHAMBERLAIN SHEA M.D.” Practice Location

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