Dr Mary Elizabeth Shepherd, MD,PHD | |
12545 Riata Vista Cir, Austin, TX 78727-6524 | |
(512) 526-1776 | |
(512) 298-1277 |
Full Name | Dr Mary Elizabeth Shepherd |
---|---|
Gender | Female |
Speciality | Dermatology |
Location | 12545 Riata Vista Cir, Austin, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1144210352 | NPI | - | NPPES |
8B8802 | Other | TX | BLUE CROSS BLUE SHIELD |
105402503 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207N00000X | Dermatology | H6599 (Texas) | Primary |
Entity Name | Oliver Street 5.01(a) Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457695413 PECOS PAC ID: 0042464125 Enrollment ID: O20130128000189 |
Mailing Address | Practice Location Address |
---|---|
Dr Mary Elizabeth Shepherd, MD,PHD Po Box 171179, Austin, TX 78717-0041 Ph: (512) 526-1776 | Dr Mary Elizabeth Shepherd, MD,PHD 12545 Riata Vista Cir, Austin, TX 78727-6524 Ph: (512) 526-1776 |
Dr. John Joseph Ghidoni Iii, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 8229 Shoal Creek Blvd, Suite#101, Austin, TX 78757 Phone: 512-371-7400 Fax: 512-371-7488 | |
Moise Levy, MD Dermatology Medicare: Medicare Enrolled Practice Location: 1301 Barbara Jordan Blvd Ste 200, Austin, TX 78723 Phone: 512-628-1920 Fax: 512-628-1921 | |
Dr. Susan Elizabeth Dozier, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 8240 N Mo Pac Expwy, Suite 355, Austin, TX 78759 Phone: 512-527-9020 Fax: 512-527-9000 | |
Dr. Gregory A. Nikolaidis, Dermatology Medicare: Medicare Enrolled Practice Location: 8825 Bee Cave Rd, Suite 100, Austin, TX 78746 Phone: 512-328-3376 Fax: 512-399-6895 | |
Amy Ayres Mcclung, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 9701 Brodie Ln Ste 106, Austin, TX 78748 Phone: 512-280-3939 Fax: 512-280-3938 | |
Stanley Tyler Hollmig, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1601 Trinity St Ste 704b, Austin, TX 78712 Phone: 512-324-7468 Fax: 512-324-7469 | |
Dr. Lauren Piilani Rimoin, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 8825 Bee Caves Rd Ste 100, Austin, TX 78746 Phone: 512-328-3376 Fax: 512-666-3767 |