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General NPI Number Information
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NPI Number | 1912160797
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Entity Type | Individual
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Provider Name | JESSICA A SHEPHERD M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/02/2008
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Last Update Date | 09/01/2023
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Provider Practice Location Address
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Address Line | 5600 W LOVERS LN STE 100
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City | DALLAS
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State | TX
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Zip | 75209-4359
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Country | US
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Telephone | 214-729-6299
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Fax | 214-935-5052
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Provider Business Mailing Address
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Address Line | 5600 W LOVERS LN STE 100
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City | DALLAS
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State | TX
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Zip | 75209-4359
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Country | US
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Telephone | 917-561-5263
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Fax | 214-935-5052
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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 | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 42442
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License Number State | KY
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