Kelly, Shawn M
Kelly, Shawn M is an individual health care provider with primary practice located at 2313 W Parker Rd , Plano TX 75023-7839. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Kelly, Shawn M can be contacted via phone (972) 612-2015.Contact Information
Primary practice address
2313 W Parker Rd
Plano TX 75023-7839
Phone: (972) 612-2015
Fax: (972) 867-5454
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2689 | Minnesota |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 5621TG | Texas |
Profile Details
| NPI number | 1003808395 |
|---|---|
| LBN Legal business name | Kelly, Shawn M |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 22nd, 2005 |
| Last updated | Oct 28th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003808395 | NPPES |
| Texas | Other | 410049426 | RAILROAD MEDICARE |
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