Healthcare Provider Details

I. General information

NPI: 1750259909
Provider Name (Legal Business Name): SHEPARD PLAYTIME THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2025
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5977 WHISTLING TREE CT
LAS VEGAS NV
89148-4586
US

IV. Provider business mailing address

5977 WHISTLING TREE CT
LAS VEGAS NV
89148-4586
US

V. Phone/Fax

Practice location:
  • Phone: 702-467-1255
  • Fax:
Mailing address:
  • Phone: 702-467-1255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT DAVID SHEPARD
Title or Position: DOCTOR OF PHYSICAL THERAPY / CEO
Credential: PT, DPT
Phone: 702-467-1255