Provider Demographics
NPI:1902346034
Name:BYROM, SHELBY (NP)
Entity type:Individual
Prefix:MRS
First Name:SHELBY
Middle Name:
Last Name:BYROM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:SHELBY
Other - Middle Name:
Other - Last Name:RING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1311 GENERAL CAVAZOS BLVD STE 305
Mailing Address - Street 2:
Mailing Address - City:KINGSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78363-7123
Mailing Address - Country:US
Mailing Address - Phone:361-592-2223
Mailing Address - Fax:361-592-1967
Practice Address - Street 1:1311 GENERAL CAVAZOS BLVD STE 305
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78363-7123
Practice Address - Country:US
Practice Address - Phone:361-592-2223
Practice Address - Fax:361-592-1967
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133460363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP02601730OtherMCRR
TX1L5022OtherMEDICARE
TXPENDINGMedicaid
TX390325402Medicaid