Individual
SHELLY ACREE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 S IH 35, STE 105, ROUND ROCK, TX 78664-6615
(512) 310-7665
(512) 310-9228
Mailing address
1201 S IH 35, STE 105, ROUND ROCK, TX 78664-6615
(512) 310-7665
(512) 310-9228
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2111322
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031DG
BLUECROSS BLUESHIELD
—
05
—
0944746-02
—
TX
Enumeration date
08/18/2015
Last updated
06/13/2016
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