MEDICARE: DAVID L SHEPHERD 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	208800000X	Urology Physician	K4242	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730166893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID L SHEPHERD MD

Provider Business Mailing Address
First Line	:	PO BOX 911230
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75391-1230
Country	:	US
Telephone Number	:	817-784-8268
Fax Number	:	817-259-1004

Provider Business Practice Location Address
First Line	:	801 W I 20 STE 1
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-5851
Country	:	US
Telephone Number	:	817-784-8268
Fax Number	:	817-417-1150

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

Provider Enumeration Date	:	12/29/2005
Last Update Date	:	02/27/2025

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Directions to “ DAVID L SHEPHERD MD” Practice Location

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