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General NPI Number Information
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NPI Number | 1710708458
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Entity Type | Individual
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Provider Name | ANNA SHELTON
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Gender | Female
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Dates
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Enumeration Date | 10/23/2024
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 6544 GREATWOOD PKWY STE A
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City | SUGAR LAND
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State | TX
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Zip | 77479-6808
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Country | US
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Telephone | 832-407-6033
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Fax |
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Provider Business Mailing Address
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Address Line | 6823 RADIANT HEIGHTS ST
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89086-1543
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Country | US
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Telephone |
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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 | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 204405
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License Number State | NV
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