Shelton, Michael Vise
Shelton, Michael Vise is an individual health care provider with primary practice located at 4222 Wendover Ave Ste 600, Odessa TX 79762-5983. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Shelton, Michael Vise can be contacted via phone (432) 552-5656.Contact Information
Primary practice address
4222 Wendover Ave Ste 600
Odessa TX 79762-5983
Phone: (432) 552-5656
Fax: (432) 552-0992
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | E8905 | Texas |
Profile Details
| NPI number | 1003810995 |
|---|---|
| LBN Legal business name | Shelton, Michael Vise |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 8th, 2005 |
| Last updated | Jul 20th, 2010 - 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 | 1003810995 | NPPES |
| Texas | Other | 89030X | BLUE CROSS/BLUE SHIELD |
| Texas | MEDICAID | 133690105 | BLUE CROSS/BLUE SHIELD |
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