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NPI Code Detail

MEDICARE: DR. JAMES GRANT SHUPE M.D.

MEDICARE:  DR. JAMES GRANT SHUPE  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
12084N0402XNeurology with Special Qualifications in Child Neurology PhysicianH6605TX
22084P0804XChild & Adolescent Psychiatry PhysicianH6605TX

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 : 1952469330
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES GRANT SHUPE M.D.
Provider Business Mailing Address
First Line : 6404 INTERNATIONAL PKWY
Second Line : SUITE 2100
City : PLANO
State : TX
Zip : 75093-8225
Country : US
Telephone Number : 972-267-1988
Fax Number : 972-267-3434
Provider Business Practice Location Address
First Line : 6404 INTERNATIONAL PKWY
Second Line : SUITE 2100
City : PLANO
State : TX
Zip : 75093-8225
Country : US
Telephone Number : 972-267-1988
Fax Number : 972-267-3434
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2006
Last Update Date : 02/10/2010

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Directions to “ DR. JAMES GRANT SHUPE M.D.” Practice Location

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