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General NPI Number Information
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NPI Number | 1740689447
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Entity Type | Organization
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Legal Business Name | SHELBY LAUREN, P.A.
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Dates
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Enumeration Date | 08/19/2014
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Last Update Date | 08/19/2014
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Provider Practice Location Address
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Address Line | 4112 LEGACY DR
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City | FRISCO
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State | TX
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Zip | 75034-0810
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Country | US
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Telephone | 214-872-1232
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Fax |
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Provider Business Mailing Address
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Address Line | 1194 RED HAWK DR
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City | FRISCO
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State | TX
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Zip | 75033-1623
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Country | US
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Telephone | 214-872-1232
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | SHELBY LISKE
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Credential |
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Telephone | 214-872-1232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 11940
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License Number State | TX
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