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General NPI Number Information
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NPI Number | 1134919921
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Entity Type | Organization
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Legal Business Name | GARY W. SHULTS, D.D.S.
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 1114 AUSTIN HWY
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City | SAN ANTONIO
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State | TX
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Zip | 78209-4844
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Country | US
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Telephone | 210-824-4621
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Fax | 210-826-7004
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Provider Business Mailing Address
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Address Line | 1114 AUSTIN HWY
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City | SAN ANTONIO
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State | TX
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Zip | 78209-4844
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Country | US
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Telephone | 210-824-4621
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Fax | 210-826-7004
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | SUSAN SHULTS
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Credential |
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Telephone | 210-824-4621
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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