Individual
ROBERT SHELTON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3504 MT VERNON AVE, FORT WORTH, TX 76103-2527
(214) 900-8360
Mailing address
PO BOX 181698, ARLINGTON, TX 76096-1698
(214) 900-8360
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
410
—
TX
Enumeration date
02/02/2022
Last updated
02/02/2022
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