MEDICARE: SHELBY PAIGE FLEWELLEN MD

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	207R00000X	Internal Medicine Physician	24408	NV

General Provider Information

NPI Number	:	1588284111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELBY PAIGE FLEWELLEN MD

Provider Business Mailing Address
First Line	:	6100 HARRIS PKWY STE 350
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-4134
Country	:	US
Telephone Number	:	817-433-5495
Fax Number	:	817-433-5582

Provider Business Practice Location Address
First Line	:	6100 HARRIS PKWY STE 350
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-4134
Country	:	US
Telephone Number	:	817-433-5495
Fax Number	:	817-433-5582

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

Provider Enumeration Date	:	04/23/2020
Last Update Date	:	03/10/2026

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