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NPI Code Detail

MEDICARE: MIKAYLA SHORTEN DO

MEDICARE: MIKAYLA SHORTEN DO
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207P00000XEmergency Medicine PhysicianW0730TX

General Provider Information

NPI Number : 1538864707
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIKAYLA SHORTEN DO
Provider Business Mailing Address
First Line : 600 ELIZABETH ST
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78404-2235
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 600 ELIZABETH ST
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78404-2235
Country : US
Telephone Number : 361-902-4100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2023
Last Update Date : 01/21/2026

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