Healthcare Provider Details

I. General information

NPI: 1265828362
Provider Name (Legal Business Name): MEGAN ELIZABETH SHELTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2015
Last Update Date: 12/21/2023
Certification Date: 12/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12319 N MOPAC EXPY STE 100
AUSTIN TX
78758-2486
US

IV. Provider business mailing address

1601 E PFLUGERVILLE PKWY STE 1102
PFLUGERVILLE TX
78660-6148
US

V. Phone/Fax

Practice location:
  • Phone: 512-837-3376
  • Fax:
Mailing address:
  • Phone: 512-252-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number4301502324
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberT2751
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number4301502324
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberT2751
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: