Justin Shields

Primary specialty

SpecialistTaxonomy code 174400000X

License

1232407 Issued in TX

Practice address

307 E Ovilla Rd
Suite # 100
Red Oak, TX 75154-3898

Phone

(972) 576-2920

Fax

(972) 617-3930

NPI assigned

May 8, 2014

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1399507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399507200000",
    "number": "1205247582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6119 GREENVILLE AVE",
            "address_2": "SUITE # 433",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752061910",
            "telephone_number": "972-576-2920",
            "fax_number": "972-617-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 E OVILLA RD",
            "address_2": "SUITE # 100",
            "city": "RED OAK",
            "state": "TX",
            "postal_code": "751543898",
            "telephone_number": "972-576-2920",
            "fax_number": "972-617-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "JUSTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-08",
        "last_updated": "2014-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "1232407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zaria Sanders, PT, DPT
• John Bryan Sappington, DC
• Steven J Seligman, M.D.
• Senior Care Consultants (Red Oak Health & Rehab Center)
• Serving Hands Transportation Services LLC
• Seena Shyu, O.D.
• Offiong Sims
• Skulpted Kontour LLC (SKS Caring Hands)
• Michael Zachariah Smith, PTA
• Tae Jin Song, D.D.S.

• Specialist in Red Oak, TX
• Providers in Red Oak, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2014; 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.