Provider Demographics
NPI:1942294145
Name:SINGLETON, SHELLY (PA)
Entity Type:Individual
Prefix:MR
First Name:SHELLY
Middle Name:
Last Name:SINGLETON
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 OLD BEEVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:REFUGIO
Mailing Address - State:TX
Mailing Address - Zip Code:78377-4404
Mailing Address - Country:US
Mailing Address - Phone:361-526-7070
Mailing Address - Fax:361-526-7070
Practice Address - Street 1:116 OLD BEEVILLE HWY
Practice Address - Street 2:
Practice Address - City:REFUGIO
Practice Address - State:TX
Practice Address - Zip Code:78377-4404
Practice Address - Country:US
Practice Address - Phone:361-526-7070
Practice Address - Fax:361-526-7070
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-02
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA00726363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS38535Medicare UPIN