| Tim Shepherd Md Pa | |
|
500 N Valley Pkwy Ste 101 Lewisville TX 75067-3552 | |
| (972) 420-8777 | |
| (972) 219-1978 |
| Full Name | Tim Shepherd Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 500 N Valley Pkwy, Lewisville, Texas |
| Authorized Official Name and Position | Tim S Shepherd (OWNER) |
| Authorized Official Contact | 9724208777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tim Shepherd Md Pa 500 N Valley Pkwy Ste 101 Lewisville TX 75067-3552 Ph: (972) 420-8777 | Tim Shepherd Md Pa 500 N Valley Pkwy Ste 101 Lewisville TX 75067-3552 Ph: (972) 420-8777 |
| NPI Number | 1255655007 |
|---|---|
| Provider Enumeration Date | 03/23/2010 |
| Last Update Date | 09/30/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255655007 | NPI | - | NPPES |
| 00Z699 | Other | TX | BLUE CROSS/BLUE SHIELD |
| 212009901 | Medicaid | TX | |
| B26392 | Other | TX | COMMERCIAL |
| DQ2129 | Other | TX | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | F4518 (Texas) | Primary |
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