Individual
JUSTIN SHIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
307 E OVILLA RD, SUITE # 100, RED OAK, TX 75154-3898
(972) 576-2920
(972) 617-3930
Mailing address
6119 GREENVILLE AVE, SUITE # 433, DALLAS, TX 75206-1910
(972) 576-2920
(972) 617-3930
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1232407
TX
Other
Enumeration date
05/08/2014
Last updated
05/08/2014
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