1013198209 NPI number — WILLIAM R SHELDON, JR., MD PA

Table of content: (NPI 1013198209)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013198209 NPI number — WILLIAM R SHELDON, JR., MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WILLIAM R SHELDON, JR., MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013198209
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5930 W PARKER RD
Provider Second Line Business Mailing Address:
#700
Provider Business Mailing Address City Name:
PLANO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75093-6419
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-943-7626
Provider Business Mailing Address Fax Number:
972-608-5223

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5930 W PARKER RD
Provider Second Line Business Practice Location Address:
#700
Provider Business Practice Location Address City Name:
PLANO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75093-6419
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-943-7626
Provider Business Practice Location Address Fax Number:
972-608-5223
Provider Enumeration Date:
11/16/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SHELDON
Authorized Official First Name:
JANIS
Authorized Official Middle Name:
IRENE
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
972-943-7626

Provider Taxonomy Codes

  • Taxonomy code: 207RE0101X , with the licence number:  F1999 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)