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Individual

ELIJAH CLIFTON SHAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
FNP-C

Contact information

Practice address
1207 S BAILEY ST, ELECTRA, TX 76360-3221
(940) 495-3981
Mailing address
310 W WHARTON AVE, ELECTRA, TX 76360-2320

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
962505
TX
363LF0000X
Family Nurse Practitioner
1230691
TX

Other

Enumeration date
01/27/2026
Last updated
03/31/2026
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