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General NPI Number Information
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NPI Number | 1891586673
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Entity Type | Individual
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Provider Name | SHELDON HARGIS
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Gender | Male
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 5504 WAYNE AVE
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City | LUBBOCK
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State | TX
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Zip | 79414-4137
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Country | US
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Telephone | 806-786-8136
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Fax |
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Provider Business Mailing Address
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Address Line | 1712 PONTIAC AVE
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City | LUBBOCK
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State | TX
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Zip | 79416-6910
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Country | US
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Telephone | 806-786-8136
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 13447
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 115890
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License Number State | TX
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