Healthcare Provider Details

I. General information

NPI: 1891503074
Provider Name (Legal Business Name): SHELBY LAINE BILBREY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2024
Last Update Date: 03/19/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 SPENCER HWY
PASADENA TX
77504-1202
US

IV. Provider business mailing address

2010 SEQUOIA ST
KEMAH TX
77565-2129
US

V. Phone/Fax

Practice location:
  • Phone: 713-359-2000
  • Fax:
Mailing address:
  • Phone: 346-813-9559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number1193139
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: