Jack Shirley

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12068 Issued in TX

Practice address

7826 Louis Pasteur Ste 103
San Antonio, TX 78229-3410

Phone

(210) 615-8357

Fax

(210) 615-8359

NPI assigned

Apr 1, 2008

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207008000000",
    "number": "1376715201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7826 LOUIS PASTEUR, STE 103",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7826 LOUIS PASTEUR STE 103",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293410",
            "telephone_number": "210-615-8357",
            "fax_number": "210-615-8359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRLEY",
        "first_name": "JACK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "12068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leila Shirali, FNP-C
• Khan Z Shirani, MD, MS, MPH, MBA
• Paula Shireman, MD
• Lorraine Shirley-Wenzel, M.D.
• Emrie T Shirley, RBT
• Jared Quincy Shirley, D.C.
• Kobe Shirley
• Gautam Shirodkar, BDS MS
• Katie Shiroma
• Valerie Fisher Shiu, MD

• General Practice Dentistry in San Antonio, TX
• Providers in San Antonio, 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 Apr 1, 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.