Active NPI
Linda Carol Shackelford, MD
- Military Health Care Provider
- Houston, TX
National Provider Identifier
1639283815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Military Health Care Provider
- License
- J3603
- Practice address
- 2101 Nasa Pkwy
Mail Code SK
Houston, TX 77058-3607 - Phone
- (281) 483-7100
- NPI assigned
- Aug 18, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | J3603 | TX | Primary |
Addresses
Primary practice location
2101 Nasa Pkwy
Mail Code SK
Houston, TX 77058-3607
Mailing address
15111 Harness LN
Webster, TX 77598-1801
Phone (832) 741-3187
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| J3603 | TX | MD | Military Health Care Provider |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639283815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15111 HARNESS LN",
"city": "WEBSTER",
"state": "TX",
"postal_code": "775981801",
"telephone_number": "832-741-3187"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 NASA PKWY",
"address_2": "MAIL CODE SK",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770583607",
"telephone_number": "281-483-7100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHACKELFORD",
"first_name": "LINDA",
"middle_name": "CAROL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": "TX",
"license": "J3603",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.