Organization
SHANE T SEROYER MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE THOMAS SEROYER MD (PRESIDENT)
(817) 419-0303
Entity
Organization
Contact information
Practice address
515 W MAYFIELD RD STE 116, ARLINGTON, TX 76014-2084
(817) 419-0303
(817) 468-5963
Mailing address
515 W MAYFIELD RD STE 116, ARLINGTON, TX 76014-2084
(817) 419-0303
(817) 468-5963
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
N1887
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204613801
—
TX
Enumeration date
09/07/2011
Last updated
09/07/2011
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