Provider Demographics
NPI:1346711090
Name:STEPHANIE SHISLER MD PA
Entity type:Organization
Organization Name:STEPHANIE SHISLER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHISLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-533-4465
Mailing Address - Street 1:1005 W RALPH HALL PKWY STE 107
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6663
Mailing Address - Country:US
Mailing Address - Phone:469-769-1961
Mailing Address - Fax:469-769-1905
Practice Address - Street 1:1005 W RALPH HALL PKWY STE 107
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6663
Practice Address - Country:US
Practice Address - Phone:682-237-1546
Practice Address - Fax:817-622-8068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-06
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty