Organization
SHORE & ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT J SHORE PHD (PRESIDENT)
(903) 939-8760
Entity
Organization
Contact information
Practice address
804 SPRING CREEK DR, TYLER, TX 75703
(903) 939-8760
(903) 939-8760
Mailing address
804 SPRING CREEK DR, TYLER, TX 75703
(903) 939-8760
(903) 939-8760
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
24292
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040822101
—
TX
05
—
11601-160-01
—
TX
Enumeration date
05/15/2008
Last updated
05/15/2008
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