Individual
THOMAS O SHELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1406 WILD CAT HOLW, WEST LAKE HILLS, TX 78746-3622
(512) 330-0918
(512) 328-3694
Mailing address
1406 WILD CAT HOLW, WEST LAKE HILLS, TX 78746-3622
(512) 330-0918
(512) 328-3694
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
D5206
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139107015
—
TX
01
—
43348
STATE LICENSE
MN
01
—
5608
STATE LICENSE
AZ
01
—
7455
STATE LICENSE
TN
Enumeration date
03/31/2006
Last updated
04/16/2009
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