Healthcare Provider Details

I. General information

NPI: 1205244753
Provider Name (Legal Business Name): ZACHARY CLINTON SHEPPARD FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2014
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7474 N GRAND PKWY W C1 400
SPRING TX
77379-1570
US

IV. Provider business mailing address

930 FROSTWOOD DR STE 2.200
HOUSTON TX
77024-2450
US

V. Phone/Fax

Practice location:
  • Phone: 832-717-7825
  • Fax: 832-717-7826
Mailing address:
  • Phone: 713-338-5502
  • Fax: 713-338-6500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP126026
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: