Provider Demographics
NPI:1619108149
Name:SHEARER, MELISSA A (PA-C)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:SHEARER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3786 FM 1488 RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4989
Mailing Address - Country:US
Mailing Address - Phone:281-364-8844
Mailing Address - Fax:281-364-8833
Practice Address - Street 1:8850 SIX PINES DR STE 100
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-2688
Practice Address - Country:US
Practice Address - Phone:281-364-8844
Practice Address - Fax:281-364-8833
Is Sole Proprietor?:No
Enumeration Date:2009-07-31
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06280363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX356064101Medicaid
TX449151ZJPCMedicare PIN
TX8L17367Medicare PIN