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General NPI Number Information
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NPI Number | 1922180322
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Entity Type | Individual
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Provider Name | GWENDOLYN K SHIPE MD
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Gender | Female
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 17000 PRESTON RD STE 400
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City | DALLAS
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State | TX
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Zip | 75248-1201
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Country | US
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Telephone | 972-930-0260
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Fax | 214-242-4037
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Provider Business Mailing Address
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Address Line | 17000 PRESTON RD STE 400
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City | DALLAS
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State | TX
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Zip | 75248-1201
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Country | US
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Telephone | 972-884-5911
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Fax | 214-242-4037
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | M8341
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | M8341
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License Number State | TX
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