Individual
TRAVIS SHEPARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
801 N CALIFORNIA ST, SOCORRO, NM 87801-4254
(575) 835-8991
(575) 838-0423
Mailing address
1894 CHAPARRAL LOOP, SOCORRO, NM 87801-3718
(575) 517-7846
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NM
Other
Enumeration date
11/02/2022
Last updated
12/07/2022
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