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NPI Code Detail

MEDICARE: DR. SHELLEY GUZMAN LENAMOND D.O.

MEDICARE: DR. SHELLEY GUZMAN LENAMOND D.O.
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
1207R00000XInternal Medicine PhysicianM2378TX

General Provider Information

NPI Number : 1629194311
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHELLEY GUZMAN LENAMOND D.O.
Provider Business Mailing Address
First Line : 2700 E BROAD ST
Second Line :
City : MANSFIELD
State : TX
Zip : 76063-5899
Country : US
Telephone Number : 682-622-2065
Fax Number : 682-622-2091
Provider Business Practice Location Address
First Line : 2700 E BROAD ST
Second Line :
City : MANSFIELD
State : TX
Zip : 76063-5899
Country : US
Telephone Number : 682-622-2065
Fax Number : 682-622-2091
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2007
Last Update Date : 04/17/2013

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