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General NPI Number Information
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NPI Number | 1346349297
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Entity Type | Individual
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Provider Name | CYNTHIA J SHEPHERD PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 5414 S BROADWAY
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City | TYLER
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State | TX
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Zip | 75703-1335
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Country | US
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Telephone | 903-581-1601
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 841656
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City | DALLAS
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State | TX
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Zip | 75284-1656
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Country | US
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Telephone | 903-531-5000
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA00873
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License Number State | TX
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