MEDICARE: LAURA L SHELTON M.D.

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	207VG0400X	Gynecology Physician	K7612	TX
2	174400000X	Specialist	K7612	TX
3	207V00000X	Obstetrics & Gynecology Physician	K7612	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760457014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA L SHELTON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 61160
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78466-1160
Country	:	US
Telephone Number	:	361-884-2904
Fax Number	:	361-371-8376

Provider Business Practice Location Address
First Line	:	5920 SARATOGA BLVD STE 110
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-4104
Country	:	US
Telephone Number	:	361-906-1277
Fax Number	:	361-906-0330

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

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	04/11/2025

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Directions to “ LAURA L SHELTON M.D.” Practice Location

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