Shore & Associates PC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

24292 Issued in TN

Legal business name

SHORE & ASSOCIATES PC

Practice address

804 Spring Creek Dr
Tyler, TX 75703

Phone

(903) 939-8760

Fax

(903) 939-8760

NPI assigned

May 15, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Robert J Shore, PHDNPI 1932326840

Title

President

Phone

(903) 939-8760

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Jerald Shore, PHD

  • Psychologist
  • Tyler, TX
  • NPI 1932326840
  NPD (past) Authorized official

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1093982258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SPRING CREEK DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75703",
            "telephone_number": "903-939-8760",
            "fax_number": "903-939-8760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 SPRING CREEK DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75703",
            "telephone_number": "903-939-8760",
            "fax_number": "903-939-8760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE & ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "SHORE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-939-8760",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "TN",
            "license": "24292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040822101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11601-160-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Annala J. Shirley, NP-C
• Sheri Shirley, COTA
• Alka Shirodkar, MD
• Pradeep S Shirodkar, MD
• Cynthia D Shivers
• Robert Jerald Shore, PHD
• Breana Nicole Short
• Herbert D Short III, M.D.
• Hope Daughtrey Short, M.D.
• Kevin A Short, MD

• Psychologist in Tyler, TX
• Providers in Tyler, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.