Provider Demographics
NPI:1003908500
Name:SHOVLIN, PATRICK WILLIAM III (MD)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:WILLIAM
Last Name:SHOVLIN
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:4370 MEDICAL ARTS DR. STE
Mailing Address - Street 2:STE 200
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028
Mailing Address - Country:US
Mailing Address - Phone:972-219-6800
Mailing Address - Fax:972-219-0053
Practice Address - Street 1:4370 MEDICAL ARTS DR.
Practice Address - Street 2:STE 200
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028
Practice Address - Country:US
Practice Address - Phone:972-219-6800
Practice Address - Fax:972-219-0053
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ6725208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX127580201Medicaid
TX00632DMedicare ID - Type Unspecified