Provider Demographics
NPI:1568517639
Name:SHOBE, MICHAEL LYNN (BC-HIS)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:LYNN
Last Name:SHOBE
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5009 UNIVERSITY AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79413-4431
Mailing Address - Country:US
Mailing Address - Phone:806-795-0188
Mailing Address - Fax:086-765-9608
Practice Address - Street 1:5009 UNIVERSITY AVE
Practice Address - Street 2:SUITE A
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413-4431
Practice Address - Country:US
Practice Address - Phone:806-795-0188
Practice Address - Fax:806-765-9608
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50424237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist