Mueller, Shannon Ray

Mueller, Shannon Ray is an individual health care provider with primary practice located at 1201 Medical Plaza Ct , Granbury TX 76048-5684. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Podiatric Medicine & Surgery Service Providers / Foot Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Mueller, Shannon Ray can be contacted via phone (817) 578-8555.

Contact Information

Primary practice address
1201 Medical Plaza Ct Granbury TX 76048-5684
Phone: (817) 578-8555
Fax: (817) 573-6234
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X DPM 1659 Texas
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X DPM 1659 Texas

Profile Details

NPI number 1528066255
LBN Legal business name Mueller, Shannon Ray
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated Feb 12th, 2016 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528066255 NPPES
Texas MEDICAID 162842201

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