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NPI Code Detail

MEDICARE: MARY M SHEPARD APN

MEDICARE: MARY M SHEPARD APN
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
1363LF0000XFamily Nurse Practitioner661009TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730131335
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY M SHEPARD APN
Provider Business Mailing Address
First Line : PO BOX 66308
Second Line :
City : HOUSTON
State : TX
Zip : 77266-6308
Country : US
Telephone Number : 832-548-5076
Fax Number : 713-523-4897
Provider Business Practice Location Address
First Line : 1415 CALIFORNIA ST
Second Line :
City : HOUSTON
State : TX
Zip : 77006-2602
Country : US
Telephone Number : 832-548-5000
Fax Number : 713-523-4897
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2006
Last Update Date : 07/25/2013

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