Provider Demographics
NPI:1356966444
Name:POPE, SHALYN R (AUDIOLOGISTS)
Entity type:Individual
Prefix:
First Name:SHALYN
Middle Name:R
Last Name:POPE
Suffix:
Gender:F
Credentials:AUDIOLOGISTS
Other - Prefix:
Other - First Name:SHALYN
Other - Middle Name:
Other - Last Name:BOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:4601 HARTFORD ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-4603
Mailing Address - Country:US
Mailing Address - Phone:325-793-3400
Mailing Address - Fax:325-793-3587
Practice Address - Street 1:4545 HARTFORD ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-4602
Practice Address - Country:US
Practice Address - Phone:325-793-3400
Practice Address - Fax:325-793-3587
Is Sole Proprietor?:No
Enumeration Date:2020-06-15
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81164231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX81164OtherCOMMERCIAL INSURANCE
TX81164Medicaid