Matsayah S. Shalom, CPM, LM
Individual provider Active NPI Midwife · Leesburg, TX
NPI 1063643278 · NPPES record last updated Aug 5, 2009
Key facts
- NPI
- 1063643278
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Midwife 176B00000X
- License
- 99081 (TX)
- Practice address
- 43 County Road 3222
Leesburg, TX 75451-4008 - Phone
- (903) 856-2728
- NPI assigned
- Aug 5, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 99081 | TX | MD | Midwife |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | 99081 | TX | Yes |
Addresses
Primary practice location
43 County Road 3222
Leesburg, TX 75451-4008
Mailing address
43 County Road 3222
Leesburg, TX 75451-4008
Phone (903) 856-2728
Other providers in Leesburg, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.