Provider Demographics
NPI:1972789832
Name:THE PHYSICIAN & TUTOR, P.A.
Entity Type:Organization
Organization Name:THE PHYSICIAN & TUTOR, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-548-0504
Mailing Address - Street 1:690 EAST LAMAR BOULEVARD
Mailing Address - Street 2:SUITE 117
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-3882
Mailing Address - Country:US
Mailing Address - Phone:817-548-0504
Mailing Address - Fax:817-861-8845
Practice Address - Street 1:690 E LAMAR BLVD
Practice Address - Street 2:SUITE 117
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-3882
Practice Address - Country:US
Practice Address - Phone:817-548-0504
Practice Address - Fax:817-861-8845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG56062084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty