Basic Information
| Provider Information | |||||||||
| NPI: | 1194953489 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SHELTON FAMILY HEALTH CARE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1771 S PRESTON RD | ||||||||
| Address2: | |||||||||
| City: | CELINA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750093860 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9723821000 | ||||||||
| FaxNumber: | 9723821167 | ||||||||
| Practice Location | |||||||||
| Address1: | 1771 S PRESTON RD | ||||||||
| Address2: | |||||||||
| City: | CELINA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750093860 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9723821000 | ||||||||
| FaxNumber: | 9723821167 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2009 | ||||||||
| LastUpdateDate: | 06/25/2009 | ||||||||
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| AuthorizedOfficialLastName: | SHELTON | ||||||||
| AuthorizedOfficialFirstName: | KEVIN | ||||||||
| AuthorizedOfficialMiddleName: | JAMES | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 9723821000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | N1893 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.