Individual
SAMUEL SHELBURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
L2641
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
173567204 (MDACC)
—
TX
01
—
173567205
MEDICAID-CSHCN
TX
01
—
8U4296
BCBS (MDACC)
TX
01
—
P00876959
RR MEDICARE (MDACC)
TX
Enumeration date
10/12/2006
Last updated
01/22/2021
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