MEDICARE: HELEN DIANE SHORE ATC, LAT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer	AT3380	TX

General Provider Information

NPI Number	:	1043542806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HELEN DIANE SHORE ATC, LAT

Provider Business Mailing Address
First Line	:	201 WHISPERING PINE DR
Second Line	:
City	:	HAUGHTON
State	:	LA
Zip	:	71037-9512
Country	:	US
Telephone Number	:	903-279-2603
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 SANDCRAB BLVD
Second Line	:
City	:	PORT LAVACA
State	:	TX
Zip	:	77979-2424
Country	:	US
Telephone Number	:	361-551-2698
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2010
Last Update Date	:	02/04/2010

Similar Medicare Providers

1285910620 — MR. FRANK M PARKER IV ATC, LAT
Practice Location Address:

201 SANDCRAB BLVD
PORT LAVACA, TX
77979-2424

Practice Phone: 361-551-2698
Practice Fax: 361-551-2638

1881567436 — TAMARA PATRICE NEILSON PHMNP
Practice Location Address:

1380 SW IMPORT DR STE 205
PORT ST LUCIE, FL
34953-2424

Practice Phone: 772-210-7554
Practice Fax:

1942473178 — C. R. HEIRTZLER, JR., D.D.S., INC.
Practice Location Address:

3312 MEDICAL TRIANGLE DRIVE
PORT ARTHUR, TX
77642-2424

Practice Phone: 409-962-5311
Practice Fax: 409-963-3192

1346686714 — GEORGE HARRIS
Practice Location Address:

152 TORRINGTON ST
PORT CHARLOTTE, FL
33954-2424

Practice Phone: 941-585-0967
Practice Fax:

1437767993 — HANNAH LABELLA-TIMS
Practice Location Address:

2424 AFFINITY LN
NORTH PORT, FL
34286-7657

Practice Phone: 860-918-5914
Practice Fax:

1174202014 — W1 PROPERTIES LLC
Practice Location Address:

3308 MEDICAL TRIANGLE ST
PORT ARTHUR, TX
77642-2424

Practice Phone: 409-549-4919
Practice Fax:

Directions to “ HELEN DIANE SHORE ATC, LAT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.