Provider Demographics
NPI:1801230867
Name:SHOTWELL, JOSEPH SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:SCOTT
Last Name:SHOTWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0193
Mailing Address - Country:US
Mailing Address - Phone:409-772-0770
Mailing Address - Fax:409-747-4010
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-0193
Practice Address - Country:US
Practice Address - Phone:409-772-0770
Practice Address - Fax:409-747-4010
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-22
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0855X
TXBP100463302084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry