Shelli Richter Pruski, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21647 Issued in TX

Practice address

800 N Bryant St
Pleasanton, TX 78064-2550

Phone

(830) 569-2500

Fax

(830) 281-6436

NPI assigned

Aug 5, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073522702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 930",
            "city": "POTH",
            "state": "TX",
            "postal_code": "781470930",
            "telephone_number": "830-484-1259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N BRYANT ST",
            "city": "PLEASANTON",
            "state": "TX",
            "postal_code": "780642550",
            "telephone_number": "830-569-2500",
            "fax_number": "830-281-6436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUSKI",
        "first_name": "SHELLI",
        "middle_name": "RICHTER",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Marie Poorboy, LVN
• Poteet Isd
• William I Powell Jr., PHARMACIST
• Christopher Mark Prough, O.D.
• Valarie Ann Prough, CCC-SLP
• Quality Ambulance Service
• Quc Pleasanton LLC
• Fnu Rajlakshmi, M.D.
• Ariana Ramirez
• Carol Sue Ransom-Kothman, PTA

• General Practice Dentistry in Pleasanton, TX
• Providers in Pleasanton, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.