Provider Demographics
NPI:1588788848
Name:BRISCOE, SHELIA DENISE (MD)
Entity type:Individual
Prefix:
First Name:SHELIA
Middle Name:DENISE
Last Name:BRISCOE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6200 SAVOY DR
Mailing Address - Street 2:STE 540
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-3338
Mailing Address - Country:US
Mailing Address - Phone:281-342-3400
Mailing Address - Fax:281-342-3404
Practice Address - Street 1:1229 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-2135
Practice Address - Country:US
Practice Address - Phone:281-342-3400
Practice Address - Fax:281-342-3404
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG7397207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F20866OtherCORPORATE INDIVIDUAL MEDICARE PTAN
TX0088RQOtherCORPORATE BCBS GROUP NUMBER
TX0A3548OtherCORPORATE GROUP MEDICARE PTAN
TX8BP150OtherCORPORATE BCBS INDIVIDUAL NUMBER