Provider Demographics
NPI:1194205559
Name:SHELTON, ALISON H (PTA)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:H
Last Name:SHELTON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18557 COUNTY ROAD 3409
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:TX
Mailing Address - Zip Code:75758-7515
Mailing Address - Country:US
Mailing Address - Phone:903-245-6666
Mailing Address - Fax:
Practice Address - Street 1:18557 COUNTY ROAD 3409
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:TX
Practice Address - Zip Code:75758-7515
Practice Address - Country:US
Practice Address - Phone:903-245-6666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2034518225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant