Healthcare Provider Details

I. General information

NPI: 1255903134
Provider Name (Legal Business Name): AUSTIN SHEIL PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2021
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 NE 72ND ST
GLADSTONE MO
64119-7401
US

IV. Provider business mailing address

130 S BEMISTON AVE STE 200
SAINT LOUIS MO
63105-1913
US

V. Phone/Fax

Practice location:
  • Phone: 816-268-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2025005327
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: