Shelley Poe Roaten JR.
Family Doctor - Adult Medicine
5323 Harry Hines Blvd
Dallas
, Texas 75390-7208
Shelley Poe Roaten JR.
Family Doctor - Adult Medicine
5323 Harry Hines Blvd
Dallas
, Texas 75390-7208
(214) 648-8259
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About
Features
Specialties
- Family Doctor - Adult Medicine
Languages spoken
- English
Location
First Address
- Shelley Poe Roaten JR.
- Po Box 845347
- Dallas, TX
- Zip : 75284-5347
- Phone : (214) 648-8259
Second Address
- Shelley Poe Roaten JR.
- 5323 Harry Hines Blvd
- Dallas, TX
- Zip : 75390-7208
- Phone : (214) 648-8259
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QA0505X | Family Doctor - Adult Medicine | E2822 | TX |
National Provider Identifier
| NPI | 1336101377 |
|---|---|
| Provider Name | Shelley Poe Roaten JR. |
| First Address | Dallas, TX 75284-5347 |
| Second Address | Dallas, TX 75390-7208 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/04/2006 |
| Last Update Date | 31/03/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| B25960 | (02) |
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.