Individual
HARVEY R SHADBOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1501 S COULTER ST, AMARILLO, TX 79106-1770
(806) 354-1000
Mailing address
PO BOX 2656, BRYAN, TX 77805-2656
(806) 355-9595
(806) 353-1589
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
231247
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
088863802
—
TX
01
—
430028516
RR MEDICARE
GA
Enumeration date
05/11/2006
Last updated
07/02/2008
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