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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 14 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 1003810995 NPPES
Texas Other 89030X BLUE CROSS/BLUE SHIELD
Texas MEDICAID 133690105 BLUE CROSS/BLUE SHIELD

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