Shane T Seroyer MD PA

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

N1887 Issued in TX

Legal business name

SHANE T SEROYER MD PA

Practice address

515 W Mayfield Rd Ste 116
Arlington, TX 76014-2084

Phone

(817) 419-0303

Fax

(817) 468-5963

NPI assigned

Sep 7, 2011

Organization subpart

No

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

Authorized official

Name

Shane Thomas Seroyer, MD

Title

President

Phone

(817) 419-0303

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315353600000",
    "number": "1902187701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W MAYFIELD RD STE 116",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760142084",
            "telephone_number": "817-419-0303",
            "fax_number": "817-468-5963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W MAYFIELD RD STE 116",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760142084",
            "telephone_number": "817-419-0303",
            "fax_number": "817-468-5963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANE T SEROYER MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-07",
        "last_updated": "2011-09-07",
        "status": "A",
        "authorized_official_last_name": "SEROYER",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-419-0303",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "TX",
            "license": "N1887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204613801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samiullah Muhammad Shahid
• Susan Shireen Shahsavari, OTR/L
• Babu Shaik
• Munawar S Shaikh, LVN
• Nick Charles Shamala
• K J Shankar, MD
• Aditya Rishi Sharma, MD
• Barsha Sharma, FNP-C
• Nishana Khanal Sharma, NP
• Ritika Sharma, MD

• Sports Medicine (Orthopaedic Surgery) Physician in Arlington, TX
• Providers in Arlington, TX by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; 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.