Individual
MRS. SHELBY NICOLE O'TETER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 E ROYAL LN STE 290, IRVING, TX 75039-3602
(855) 832-6727
Mailing address
400 E ROYAL LN STE 290, IRVING, TX 75039-3602
(855) 832-6727
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
RBT-16-1798-42267
TX
Other
Enumeration date
09/24/2018
Last updated
09/24/2018
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