Provider Demographics
NPI:1679932156
Name:DUNCAN, SHELSEY (LAT)
Entity type:Individual
Prefix:MS
First Name:SHELSEY
Middle Name:
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 FRIAR TUCK DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-3426
Mailing Address - Country:US
Mailing Address - Phone:817-856-9720
Mailing Address - Fax:
Practice Address - Street 1:1909 FRIAR TUCK DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-3426
Practice Address - Country:US
Practice Address - Phone:817-856-9720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-12
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT55052255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer