Provider Demographics
NPI:1083245336
Name:ELDER, SHELBY MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:SHELBY
Middle Name:MARIE
Last Name:ELDER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6130 W PARKER RD STE 502
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-7993
Mailing Address - Country:US
Mailing Address - Phone:972-238-0512
Mailing Address - Fax:972-378-6925
Practice Address - Street 1:6130 W PARKER RD STE 502
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-7993
Practice Address - Country:US
Practice Address - Phone:972-238-0512
Practice Address - Fax:972-378-6925
Is Sole Proprietor?:No
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14323111NR0400X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation