Ty Shields
Student in an Organized Health Care Education/Training Program in Arlington, TX. Individual provider (NPI-1).
NPI number1245032986
StatusActive
Last updated in NPPESMar 25, 2025
Details
- NPI
- 1245032986
- Entity type
- Individual (NPI-1)
- Name
- Ty Shields
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 25, 2025
- Certification date
- Mar 24, 2025
- Last updated
- Mar 25, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
3301 Matlock RdArlington, TX 76015-2908
Phone 682-509-6200
Mailing address
3301 Matlock RdArlington, TX 76015-2908
Phone 682-220-4073
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