Provider Demographics
NPI:1386073195
Name:SHEPHERD, TERREL JOHNSON III (RN, BSN)
Entity type:Individual
Prefix:MR
First Name:TERREL
Middle Name:JOHNSON
Last Name:SHEPHERD
Suffix:III
Gender:M
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14402 PELICAN MARSH DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-6861
Mailing Address - Country:US
Mailing Address - Phone:281-660-7895
Mailing Address - Fax:
Practice Address - Street 1:14402 PELICAN MARSH DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-6861
Practice Address - Country:US
Practice Address - Phone:281-660-7895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker