Individual
BRYAN SCOTT SHAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1050 E LOOP 304, SUITE 200, CROCKETT, TX 75835-1814
(936) 544-5132
Mailing address
5790 S STATE HIGHWAY 19, ELKHART, TX 75839-2014
(903) 724-1976
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10510
TX
Other
Enumeration date
08/19/2016
Last updated
08/19/2016
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