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NPI Code Detail

MEDICARE: SHONTEL TERRELL

MEDICARE:   SHONTEL  TERRELL
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
1164X00000XLicensed Vocational Nurse220673TX

General Provider Information

NPI Number : 1679032114
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHONTEL TERRELL
Provider Business Mailing Address
First Line : 6531 DAVENPORT BAY
Second Line :
City : CONVERSE
State : TX
Zip : 78109-3800
Country : US
Telephone Number : 210-884-7876
Fax Number :
Provider Business Practice Location Address
First Line : 6531 DAVENPORT BAY
Second Line :
City : CONVERSE
State : TX
Zip : 78109-3800
Country : US
Telephone Number : 210-884-7876
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2019
Last Update Date : 03/14/2019

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Directions to “ SHONTEL TERRELL ” Practice Location

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