Individual
SHELLY SKARIAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1001 W SOUTHLAKE BLVD, SOUTHLAKE, TX 76092-6010
(817) 865-1048
Mailing address
3125 RIVERSIDE DR, CARROLLTON, TX 75007-3732
(469) 583-4797
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
AP142218
TX
Other
Enumeration date
07/29/2019
Last updated
07/29/2019
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