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General NPI Number Information
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NPI Number | 1215964770
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Entity Type | Individual
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Provider Name | THOMAS R SHELOR OD PA
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Gender | Male
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 01/18/2008
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Provider Practice Location Address
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Address Line | 401 S CLAIRBORNE RD STE B
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City | OLATHE
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State | KS
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Zip | 66062-1735
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Country | US
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Telephone | 913-782-1213
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Fax | 913-782-4801
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Provider Business Mailing Address
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Address Line | 401 S CLAIRBORNE RD STE B
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City | OLATHE
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State | KS
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Zip | 66062-1735
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Country | US
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Telephone | 913-782-1213
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Fax | 913-782-4801
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1075-2
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License Number State | KS
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