Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 1351 | TX |
NPI | 1043243256 |
---|---|
Provider Name | Dr. Karry Ann Shebetka |
First Address | San Antonio, TX 78233-6213 |
Second Address | San Antonio, TX 78240-1502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 11/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
113416504 | (05) | TX |
8CE403 | BCBSTX (01) | TX |
U64602 | (02) | TX |