Individual
DR. JESSICA LEIGH SHELLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6020 W PARKER RD STE 200, PLANO, TX 75093-8172
(972) 608-5000
(972) 473-3929
Mailing address
6020 W PARKER RD STE 200, PLANO, TX 75093-8172
(972) 473-3947
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
M9650
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M9650
TEXAS MEDICAL LICENSE
TX
Enumeration date
10/12/2006
Last updated
06/29/2020
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