Provider Demographics
NPI:1013800762
Name:COLTEN, SHAWN A (MT102515)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:A
Last Name:COLTEN
Suffix:
Gender:M
Credentials:MT102515
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 LISA ANN AVE
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-5724
Mailing Address - Country:US
Mailing Address - Phone:956-357-3150
Mailing Address - Fax:
Practice Address - Street 1:2404 S F ST STE C
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552-7591
Practice Address - Country:US
Practice Address - Phone:956-622-3009
Practice Address - Fax:956-368-5051
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist