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General NPI Number Information
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NPI Number | 1992035166
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Entity Type | Organization
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Legal Business Name | MILTON W SHEPPERD, DO, PA
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Dates
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Enumeration Date | 01/11/2010
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Last Update Date | 01/11/2010
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Provider Practice Location Address
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Address Line | 113 BROADMOOR ST
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City | MEADOWLAKES
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State | TX
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Zip | 78654-6601
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Country | US
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Telephone | 830-693-1792
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Fax | 830-693-1685
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Provider Business Mailing Address
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Address Line | PO BOX 1930
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City | MARBLE FALLS
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State | TX
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Zip | 78654-2680
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Country | US
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Telephone | 830-693-1792
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Fax | 830-693-1685
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Authorized Official
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Title or Position | PRESIDENT
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Name | MILTON SHEPPERD
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Credential | DO
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Telephone | 512-508-4312
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | J6722
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License Number State | TX
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