Provider Demographics
NPI:1962477125
Name:SHEWARD, SCOTT E (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:E
Last Name:SHEWARD
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 1:1004 N BIG SPRING ST
Mailing Address - Street 2:STE 620
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-3354
Mailing Address - Country:US
Mailing Address - Phone:432-570-1421
Mailing Address - Fax:432-570-1427
Practice Address - Street 1:1004 N BIG SPRING ST
Practice Address - Street 2:SUITE 620
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-3354
Practice Address - Country:US
Practice Address - Phone:432-570-1421
Practice Address - Fax:432-570-1427
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG98042085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX86R223OtherDIA BCBSTX PROV#
TX81759ROtherSWMI BCBS TX PROV#
TX136982906Medicaid
TX136982910OtherDIA CHCSN PROV#
TX81759RMedicare PIN
TX81759ROtherSWMI BCBS TX PROV#
TX86R223OtherDIA BCBSTX PROV#