Provider Demographics
NPI:1962846386
Name:ROBENIOL, SHELLEY RACHEL (DO)
Entity Type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:RACHEL
Last Name:ROBENIOL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:645 E STATE HIGHWAY 121 STE 600
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-7942
Mailing Address - Country:US
Mailing Address - Phone:972-745-7500
Mailing Address - Fax:972-956-8887
Practice Address - Street 1:5644 PRESTON RD
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-7420
Practice Address - Country:US
Practice Address - Phone:972-529-4545
Practice Address - Fax:214-872-4323
Is Sole Proprietor?:No
Enumeration Date:2013-04-29
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
TXQ9895207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program