Dr. Michael Vise Shelton
Family Doctor
4222 Wendover Ave Ste 600
Odessa
, Texas 79762-5983
Dr. Michael Vise Shelton
Family Doctor
4222 Wendover Ave Ste 600
Odessa
, Texas 79762-5983
(432) 552-0992
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About
Features
Specialties
- Family Doctor
Languages spoken
- English
Location
First Address
- Dr. Michael Vise Shelton
- 4222 Wendover Ave Ste 600
- Odessa, TX
- Zip : 79762-5983
- Fax : (432) 552-0992
- Phone : (432) 552-5656
Second Address
- Dr. Michael Vise Shelton
- 4222 Wendover Ave Ste 600
- Odessa, TX
- Zip : 79762-5983
- Fax : (432) 552-0992
- Phone : (432) 552-5656
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207Q00000X | Family Doctor | E8905 | TX |
National Provider Identifier
| NPI | 1003810995 |
|---|---|
| Provider Name | Dr. Michael Vise Shelton |
| First Address | Odessa, TX 79762-5983 |
| Second Address | Odessa, TX 79762-5983 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/06/2005 |
| Last Update Date | 20/07/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 133690105 | (05) | TX |
| 89030X | BLUE CROSS/BLUE SHIELD (01) | TX |
| C21723 | (02) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.