Basic Information
| Provider Information | |||||||||
| NPI: | 1265569966 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | JOYCE M. SHOTWELL, M.D., P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3801 GASTON AVE | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752461541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2148244412 | ||||||||
| FaxNumber: | 2148244431 | ||||||||
| Practice Location | |||||||||
| Address1: | 3801 GASTON AVE | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752461541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2148244412 | ||||||||
| FaxNumber: | 2148244431 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2007 | ||||||||
| LastUpdateDate: | 01/02/2015 | ||||||||
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| AuthorizedOfficialLastName: | SHOTWELL | ||||||||
| AuthorizedOfficialFirstName: | JOYCE | ||||||||
| AuthorizedOfficialMiddleName: | M. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2148244412 | ||||||||
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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 | 207RS0012X | F4525 | TX | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | 207RP1001X | F4525 | TX | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.