Provider Demographics
NPI:1528185733
Name:COLE, SHELLEY G (MD)
Entity Type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:G
Last Name:COLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3010 SCOTT BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-6803
Mailing Address - Country:US
Mailing Address - Phone:254-773-8339
Mailing Address - Fax:254-773-5113
Practice Address - Street 1:3010 SCOTT BLVD STE 104
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-6803
Practice Address - Country:US
Practice Address - Phone:254-773-8339
Practice Address - Fax:254-773-5113
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ6961207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology