Individual provider Active NPI

Shayna Burdeaux, DO

  • Obstetrics & Gynecology Physician
  • Tyler, TX
National Provider Identifier
1386134633
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
T7177 Issued in TX
Practice address
1100 S. Beckham
Ste. 2200
Tyler, TX 75701
Phone
(903) 533-8811
Fax
(903) 593-5511
NPI assigned
May 12, 2018
Last updated
Sep 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X T7177 TX Primary

Addresses

Primary practice location

1100 S. Beckham
Ste. 2200
Tyler, TX 75701

Mailing address

1100 S. Beckham
Ste. 2200
Tyler, TX 75701
Phone (903) 533-8811

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220818003734 TX Practitioner - Obstetrics/Gynecology 2860737814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Liberty Univ College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

1000 S Beckham Ave
Tyler, TX 75701-1908
Phone (903) 590-5611

1100 E Lake St
Suite 160
Tyler, TX 75701-3357
Phone (903) 531-8126

18118 FM 344
Flint, TX 75762-6010
Phone (903) 825-3292

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
T7177TXMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince Jul 1, 2022 Accepting new patients
Etmc Physician Group Inc. CurrentSince Jul 1, 2022 Accepting new patients
Starks Medical Past Accepting new patients
Tyler Regional Hospital LLC Past Accepting new patients

Locations

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

203 Nacogdoches St
Ste 280
Jacksonville, TX 75766
Phone (903) 541-5380

501 S Ragsdale St
Jacksonville, TX 75766
Phone (903) 541-5000

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

1100 E Lake St
Ste 260
Tyler, TX 75701
Phone (903) 590-5700

Interoperability endpoints

  • Direct secure messaging: sburdeaux707224@ahs.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1526083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1386134633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S. BECKHAM",
            "address_2": "STE. 2200",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75701",
            "telephone_number": "903-533-8811",
            "fax_number": "903-593-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S. BECKHAM",
            "address_2": "STE. 2200",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75701",
            "telephone_number": "903-533-8811",
            "fax_number": "903-593-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURDEAUX",
        "first_name": "SHAYNA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-12",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "T7177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.