Individual
SHELLY RENE VANSCOYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1101 6TH AVE, FORT WORTH, TX 76104-4306
(817) 336-4638
Mailing address
1101 6TH AVE., FORT WORTH, TX 76104
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
M2849
TX
Other
Enumeration date
05/07/2007
Last updated
10/26/2010
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