Provider Demographics
NPI:1043862733
Name:SHOOK, STEVEN JAMES (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:JAMES
Last Name:SHOOK
Suffix:
Gender:M
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7505 GLENVIEW DR
Mailing Address - Street 2:STE G
Mailing Address - City:RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-8335
Mailing Address - Country:US
Mailing Address - Phone:817-819-8303
Mailing Address - Fax:
Practice Address - Street 1:14128 TANGLEBRUSH TRL
Practice Address - Street 2:
Practice Address - City:HASLET
Practice Address - State:TX
Practice Address - Zip Code:76052-3355
Practice Address - Country:US
Practice Address - Phone:817-819-8303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-12
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141329363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care