Healthcare Provider Details

I. General information

NPI: 1003741083
Provider Name (Legal Business Name): SHIFTING DIMENSIONS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 ATLAS CEDAR DR
GLENN HEIGHTS TX
75154-7953
US

IV. Provider business mailing address

412 ATLAS CEDAR DR
GLENN HEIGHTS TX
75154-7953
US

V. Phone/Fax

Practice location:
  • Phone: 424-420-7648
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name: MAYA BRENT
Title or Position: PHYSICIAN ASSISTANT
Credential: PA-C
Phone: 424-420-7648