Provider Demographics
NPI:1992786289
Name:SHIRLEY, DARREN LAYNE (MD)
Entity type:Individual
Prefix:
First Name:DARREN
Middle Name:LAYNE
Last Name:SHIRLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13737 NOEL RD STE 1600
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-1374
Mailing Address - Country:US
Mailing Address - Phone:303-933-8270
Mailing Address - Fax:214-712-2002
Practice Address - Street 1:5955 ZEAMER AVE
Practice Address - Street 2:673D MDG,
Practice Address - City:JBER
Practice Address - State:AK
Practice Address - Zip Code:99506
Practice Address - Country:US
Practice Address - Phone:907-580-6746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP12252085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology