=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699669630
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EMILY SHEVELAND, DO, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/04/2025
-----------------------------------------------------
Last Update Date | 06/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5236 W UNIVERSITY DR STE 3200
-----------------------------------------------------
City | MCKINNEY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75071-8120
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-548-1717
-----------------------------------------------------
Fax | 972-548-9190
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1904 FELIX DR
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75074-5139
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-901-0745
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING MEMBER
-----------------------------------------------------
Name | EMILY ANNE SHEVELAND
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 214-901-0745
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------