Rettig, Shaylon Dwayne

Rettig, Shaylon Dwayne is an individual health care provider with primary practice located at 333 N Santa Rosa St , San Antonio TX 78207-3108. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is his primary health care specialty. Rettig, Shaylon Dwayne can be contacted via phone (210) 704-4708.

Contact Information

Primary practice address
333 N Santa Rosa St San Antonio TX 78207-3108
Phone: (210) 704-4708
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X L9869 Texas
Allopathic & Osteopathic Physicians / Sports Medicine 2080S0010X L9869 Texas
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X L9869 Texas

Profile Details

NPI number 1679595045
LBN Legal business name Rettig, Shaylon Dwayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 24th, 2006
Last updated Jun 17th, 2021 - about 4 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 1679595045 NPPES
Texas MEDICAID 174284303
Texas MEDICAID PO#174284301
Texas Other 184276701

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