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Organization
SHADY OAKS CLINIC PLLC
Active
Organization
SHADY OAKS CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADISON WELLMAN (MEMBER)
(940) 239-5550
Entity
Organization
Contact information
Practice address
204 SHADY OAKS DR, RUNAWAY BAY, TX 76426-9462
(940) 239-5550
Mailing address
204 SHADY OAKS DR, RUNAWAY BAY, TX 76426-9462
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/04/2026
Last updated
08/04/2026
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