MEDICARE: SHELBY MONEY PAYNE DPT

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	225100000X	Physical Therapist	1233457	TX

General Provider Information

NPI Number	:	1639501190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELBY MONEY PAYNE DPT

Provider Business Mailing Address
First Line	:	1653 N VALLEY PKWY
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75077-2404
Country	:	US
Telephone Number	:	281-734-0246
Fax Number	:

Provider Business Practice Location Address
First Line	:	1997 FOREST RIDGE DR
Second Line	:
City	:	BEDFORD
State	:	TX
Zip	:	76021-1825
Country	:	US
Telephone Number	:	682-321-1217
Fax Number	:

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

Provider Enumeration Date	:	08/06/2013
Last Update Date	:	06/23/2025

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