Healthcare Provider Details

I. General information

NPI: 1306942057
Provider Name (Legal Business Name): ALAN D. SHILLER M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3323 S LOOP 256
PALESTINE TX
75801-6977
US

IV. Provider business mailing address

3323 S LOOP 256
PALESTINE TX
75801-6977
US

V. Phone/Fax

Practice location:
  • Phone: 903-723-1010
  • Fax: 903-723-0314
Mailing address:
  • Phone: 903-723-1010
  • Fax: 903-723-0314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: ALAN SHILLER
Title or Position: PRESIDENT
Credential: MD
Phone: 903-723-1010