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Individual

DR. VERNON C. SHAFFER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2604 SAINT MICHAEL DR, SUITE 410, TEXARKANA, TX 75503-2379
(903) 614-5430
(903) 614-5464
Mailing address
919 HIDDEN RDG, 6TH FLOOR, IRVING, TX 75038-3813
(469) 282-2711
(469) 282-0996

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
G6012
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110879001
AR
05
124647202
TX
05
124647205
TX
Enumeration date
12/22/2005
Last updated
01/02/2017
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