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General NPI Number Information
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NPI Number | 1265238778
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Entity Type | Organization
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Legal Business Name | SHOKR HYDRATION PLLC
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 1124 GLADE RD STE 160
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City | COLLEYVILLE
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State | TX
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Zip | 76034-4294
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Country | US
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Telephone | 817-984-3460
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Fax | 817-984-3463
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Provider Business Mailing Address
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Address Line | 1124 GLADE RD STE 160
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City | COLLEYVILLE
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State | TX
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Zip | 76034-4294
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Country | US
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Telephone | 817-984-3460
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Fax | 817-984-3463
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | AMELIA DORIS LEDBETTER
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Credential |
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Telephone | 573-803-5205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | NULL
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