Provider Demographics
NPI:1154916039
Name:SHENEMAN, TAYLOR ANDREW (PA-C)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ANDREW
Last Name:SHENEMAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6309 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-8978
Mailing Address - Country:US
Mailing Address - Phone:956-497-3691
Mailing Address - Fax:956-618-4879
Practice Address - Street 1:100 N US HIGHWAY 77 STE K
Practice Address - Street 2:
Practice Address - City:RAYMONDVILLE
Practice Address - State:TX
Practice Address - Zip Code:78580-4010
Practice Address - Country:US
Practice Address - Phone:956-394-0968
Practice Address - Fax:956-394-1137
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA14413363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical