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General NPI Number Information
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NPI Number | 1386984508
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Entity Type | Organization
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Legal Business Name | SHELBY FAMILY CLINIC
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Dates
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Enumeration Date | 02/25/2013
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Last Update Date | 02/25/2013
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Provider Practice Location Address
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Address Line | 602 HURST ST SUITE 3
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City | CENTER
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State | TX
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Zip | 75935-3414
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Country | US
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Telephone | 936-598-2933
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Fax |
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Provider Business Mailing Address
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Address Line | 602 HURST ST SUITE 3
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City | CENTER
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State | TX
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Zip | 75935-3414
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Country | US
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Telephone | 936-598-2933
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FLORENCIO SINGSON
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Credential | MD
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Telephone | 936-598-2933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | G4713
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License Number State | TX
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