Dr. Stacy Ann Shackelford
Surgeon Trauma Surgeon
3551 Roger Brooke Dr
Fort Sam Houston
, Texas 78234-4504
Dr. Stacy Ann Shackelford
Surgeon Trauma Surgeon
3551 Roger Brooke Dr
Fort Sam Houston
, Texas 78234-4504
(210) 539-9174
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About
Features
Specialties
- Surgeon
- Trauma Surgeon
Languages spoken
- English
Location
First Address
- Dr. Stacy Ann Shackelford
- 3698 Chambers Pass Ste B
- San Antonio, TX
- Zip : 78234-7767
- Phone : (210) 539-9174
Second Address
- Dr. Stacy Ann Shackelford
- 3551 Roger Brooke Dr
- Fort Sam Houston, TX
- Zip : 78234-4504
- Phone : (210) 539-9582
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FAQs
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What type of doctor is Dr. Stacy Ann Shackelford
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What is Dr. Stacy Ann Shackelford ’s gender?
Is Dr. Stacy Ann Shackelford a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208200000X | Surgeon | 280123-1205 | UT |
| N | 208600000X | Surgeon | 280123-1205 | UT |
| Y | 2086S0127X | Trauma Surgeon | D73001 | MD |
National Provider Identifier
| NPI | 1215925672 |
|---|---|
| Provider Name | Dr. Stacy Ann Shackelford |
| First Address | San Antonio, TX 78234-7767 |
| Second Address | Fort Sam Houston, TX 78234-4504 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/10/2005 |
| Last Update Date | 12/01/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 441150100 | (05) | MD |
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.