Provider Demographics
NPI:1386137776
Name:DEAN, SHELBY LYNN (DO)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:LYNN
Last Name:DEAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WILLIAM BEAUMONT ARMY MEDICAL CENTER
Mailing Address - Street 2:5005 NORTH PIEDRAS STREET ATTN: GME OFFICE
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79920
Mailing Address - Country:US
Mailing Address - Phone:915-742-2597
Mailing Address - Fax:915-742-6668
Practice Address - Street 1:WILLIAM BEAUMONT ARMY MEDICAL CENTER
Practice Address - Street 2:5005 NORTH PIEDRAS STREET ATTN: GME OFFICE
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79920
Practice Address - Country:US
Practice Address - Phone:915-742-2597
Practice Address - Fax:915-742-6668
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program