Maxwell, Shane R.

Maxwell, Shane R. is an individual health care provider with primary practice located at 3801 Scott And White Dr , Killeen TX 76543-5252. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Maxwell, Shane R. can be contacted via phone (254) 680-1100.

Contact Information

Primary practice address
3801 Scott And White Dr Killeen TX 76543-5252
Phone: (254) 680-1100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X J8662 Texas

Profile Details

NPI number 1689635740
LBN Legal business name Maxwell, Shane R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2006
Last updated Jan 28th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689635740 NPPES
Texas Other 80373F BLUE SHIELD
Texas MEDICAID 1337057-05 BLUE SHIELD
Texas Other 080162001 BLUE SHIELD
Texas Other 1337057-04 BLUE SHIELD

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