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General NPI Number Information
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NPI Number | 1114770229
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Entity Type | Individual
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Provider Name | SHANTAU A VALENTINE
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Gender | Female
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Dates
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Enumeration Date | 04/09/2024
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Last Update Date | 06/29/2025
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Provider Practice Location Address
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Address Line | 910 N DAVIS DR STE 100
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City | ARLINGTON
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State | TX
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Zip | 76012-3200
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Country | US
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Telephone | 945-954-0574
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Fax | 972-957-5215
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Provider Business Mailing Address
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Address Line | 910 N DAVIS DR STE 100
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City | ARLINGTON
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State | TX
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Zip | 76012-3200
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Country | US
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Telephone | 945-954-0574
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Fax | 972-957-5215
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1052371
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License Number State | TX
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