Shelby Taylor Wall, PA-C
Physician Assistant in Austin, TX. Individual provider (NPI-1).
NPI number1861900797
StatusActive
Last updated in NPPESJan 12, 2018
Details
- NPI
- 1861900797
- Entity type
- Individual (NPI-1)
- Name
- Shelby Taylor Wall
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 12, 2018
- Last updated
- Jan 12, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA11719 | TX | Yes |
Practice location
901 W Ben White BlvdAustin, TX 78704-6903
Phone 512-447-2211
Mailing address
2001 South Mopac ExpresswayApt 1521
Austin, TX 78746
Phone 765-432-0698
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