MS. SHELLY MARGARET STATES (NPI# 1407094667) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407094667 |
| Entity Type | Individual |
| Full Name | MS. SHELLY MARGARET STATES |
| Credential | P.A |
| Practice Address |
1353 N Travis St Liberty TX 77575-3549 |
| Mailing Address |
21542 Hawkspur Ridge St Richmond TX 77406-5259 |
| Practice Telephone | 8323979283 |
| Mailing Telephone | 8323979283 |
| Enumeration Date | 2009-01-27 |
| Last Update Date | 2012-11-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA02525 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | PHYSICIAN ASSISTANT LICENSE | PA02525 | 01 |
| Street Address |
1353 N TRAVIS ST |
| City | LIBERTY |
| State | TX |
| Zip Code | 77575-3549 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114945532 | Danny Kyaw Khine | Internal Medicine | 1353 N Travis St, Liberty, TX 77575-3549 | 2006-07-17 |
| 1679926992 | Liberty County Hospital District No 1 | Clinic/Center | 1353 N Travis St, Liberty, TX 77575-3549 | 2016-07-21 |
| 1811371701 | Liberty County Hospital District No. 1 | Medicare Defined Swing Bed Unit | 1353 N Travis St, Liberty, TX 77575-3549 | 2015-07-10 |
| 1770964991 | Susan D. Clark | Nurse Practitioner | 1353 N Travis St, Liberty, TX 77575-3549 | 2015-06-12 |
| 1295128247 | Ess of South Texas LLC | Emergency Medicine | 1353 N Travis St, Liberty, TX 77575-3549 | 2015-03-16 |
| 1922328335 | Israel Tegegne Haile | Internal Medicine | 1353 N Travis St, Liberty, TX 77575-3549 | 2010-06-08 |
| 1487889960 | Heather Reed | Physician Assistant | 1353 N Travis St, Liberty, TX 77575-3549 | 2009-05-27 |
| 1770733081 | Liberty Dayton Community Hospital | General Acute Care Hospital | 1353 N Travis St, Liberty, TX 77575-3549 | 2008-09-23 |
| 1992988539 | Lisa Gaile Odom | Registered Nurse | 1353 N Travis St, Liberty, TX 77575-3549 | 2007-12-05 |
| 1740344415 | Steven Wayne Branham | Nurse Practitioner | 1353 N Travis St, Liberty, TX 77575-3549 | 2006-12-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750981502 | Parikshit Jayant Davda | Clinic/Center | 1620 Magbolia Street, Liberty, TX 77575 | 2020-10-30 |
| 1003285156 | Divine Garden Transportation | Non-emergency Medical Transport (VAN) | 450 Mlking Dr., Liberty, TX 77575 | 2015-09-18 |
| 1689895799 | Allen R. Griffin | Eyewear Supplier (Equipment, not the service) | 2718 B N. Main St., Liberty, TX 77575 | 2007-05-02 |
| 1548362395 | Hsmtx/liberty, LLC | Skilled Nursing Facility | 1206 N Travis St, Liberty, TX 77575 | 2006-09-02 |
| 1699877530 | Lessie Frank | Licensed Vocational Nurse | 612 Highway 90, Liberty, TX 77575 | 2006-09-01 |
| 1588601827 | Trudy Poor Britz | Nurse Practitioner | 1807 Rampart, League, TX 77575 | 2006-06-02 |
| 1285680033 | Faresh Mehta | Optometrist | 2121 Hwy 146 Bypass, Liberty, TX 77575 | 2006-05-25 |
| 1922455781 | Bassam A. Hamid M.d.,p.a. Urgent Care/primarycare | Clinic/Center | 608 Travis, Liberty, TX 77575 | 2016-05-20 |
| 1508887241 | Tri-county Behavioral Healthcare | Intermediate Care Facility, Mentally Retarded | 1420 Holly St, Liberty, TX 77575-3118 | 2006-07-21 |
| 1528581220 | D&s Residential Services, Lp | Intermediate Care Facility, Mentally Retarded | 1420 Holly St, Liberty, TX 77575-3118 | 2017-07-25 |
| Find all providers in zip 77575 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205170156 | Mary Elizabeth Poston | Physician Assistant | 1201 N Travis St, Liberty, TX 77575-3539 | 2012-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831704576 | Leila Olive Adell | Physician Assistant | 1221 S Congress Ave Apt 331, Austin, TX 78704-2461 | 2020-09-10 |
| 1619591864 | Today Telemedicine Pllc | Physician Assistant | 404 Oxford St Apt 2219, Houston, TX 77007-2679 | 2020-06-03 |
| 1497384168 | Gregory C Etienne | Physician Assistant | 7400 N 4th St, Mcallen, TX 78504-1859 | 2020-04-05 |
| 1689202475 | Theodore Inthaphom | Physician Assistant | 25222 Northwest Fwy Apt 349, Cypress, TX 77429-1065 | 2020-03-29 |
| 1740816982 | Alyssa Conrad | Physician Assistant | 4818 Star Jasmine Dr, Austin, TX 78723-6059 | 2020-03-19 |
| 1114558335 | Erin Lynn Brown | Physician Assistant | 1504 Taub Loop Houston, Houston, TX 77030 | 2020-01-27 |
| 1245870930 | Jessica Grimaldo | Physician Assistant | 1200 Brooklyn Ave Ste 230, San Antonio, TX 78212-0010 | 2020-01-09 |
| 1730728528 | Holli Marie Beard | Physician Assistant | 2625 Scripture St Ste 101, Denton, TX 76201-2304 | 2019-12-27 |
| 1477191237 | Ronald Edwin Brown | Physician Assistant | 1427 Cypress Point Dr, Gunter, TX 75058-3201 | 2019-12-11 |
| 1053957910 | Rossalya Aracely Granda Gutierrez | Physician Assistant | 4150 N Collins St, Arlington, TX 76005-4547 | 2019-11-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.