Provider Demographics
NPI:1497287056
Name:GU, SHELA (MD)
Entity Type:Individual
Prefix:
First Name:SHELA
Middle Name:
Last Name:GU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 FM 1826 STE 240
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78737-1407
Mailing Address - Country:US
Mailing Address - Phone:512-288-9669
Mailing Address - Fax:512-498-0317
Practice Address - Street 1:7900 FM 1826 STE 240
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78737-1407
Practice Address - Country:US
Practice Address - Phone:512-288-9669
Practice Address - Fax:512-498-0317
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-01
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS5909208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty