Provider Demographics
NPI:1376698704
Name:SEMBLER, SHELLEY (BS,DC)
Entity Type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:
Last Name:SEMBLER
Suffix:
Gender:F
Credentials:BS,DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 PADRE BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SOUTH PADRE ISLAND
Mailing Address - State:TX
Mailing Address - Zip Code:78597-7048
Mailing Address - Country:US
Mailing Address - Phone:956-761-6006
Mailing Address - Fax:956-761-6002
Practice Address - Street 1:3311 PADRE BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:SOUTH PADRE ISLAND
Practice Address - State:TX
Practice Address - Zip Code:78597-7048
Practice Address - Country:US
Practice Address - Phone:956-761-6006
Practice Address - Fax:956-761-6002
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6010111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6010OtherLICENSE
TX00755KMedicare ID - Type Unspecified
TXU49216Medicare UPIN