Individual
CYNTHIA J SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5414 S BROADWAY, TYLER, TX 75703-1335
(903) 581-1601
Mailing address
PO BOX 841656, DALLAS, TX 75284-1656
(903) 531-5000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00873
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
298380104
—
TX
05
—
298380105
—
TX
05
—
298380106
—
TX
05
—
298380107
—
TX
01
—
75-0818167-015
TRICARE
TX
01
—
75-0818167-022
TRICARE
TX
01
—
75-0818167-044
TRICARE
TX
01
—
75-0818167-048
TRICARE
TX
01
—
75-1976930-005
TRICARE
TX
01
—
75-2616977-001
TRICARE
TX
01
—
75-2616977-002
TRICARE
TX
01
—
75-2616977-028
TRICARE
TX
01
—
75-2616977-129
TRICARE
TX
01
—
87N530
BCBS
TX
01
—
P01761917
RAIL ROAD MEDICARE
TX
01
—
P01762496
RAIL ROAD MEDICARE
TX
Enumeration date
09/21/2006
Last updated
12/10/2025
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