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Mr. David Shane Angelo, NP
Acute Care Nurse Practitioner in Tyler, Texas
NPI 1285210815

David Shane Angelo is an Acute Care Nurse Practitioner based in Tyler, TX and is specialized in Acute Care. David Shane Angelo practices in Tyler, TX and has the professional credentials of NP. The NPI Number for David Shane Angelo is 1285210815 and holds a License No. 1032557 (Texas).

The current practice location address for David Shane Angelo is 630 S Fleishel Ave, Tyler, TX and can be reached out via phone at 903-606-5560. You can also correspond with David Shane Angelo through the mailing address at 520 DOUGLAS BLVD, TYLER, TX - 75702-8307 (mailing address contact number: 903-606-6400).

Location: 630 S Fleishel Ave, Tyler, TX, 75702-8307
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Provider Profile Details
NPI Number
1285210815
Provider Name
David Shane Angelo
Credential
NP
Provider Entity Type
Individual
Gender
Male
Address
630 S Fleishel Ave, Tyler, TX, 75702-8307
Phone Number
903-606-5560
Fax Number
Provider Enumeration Date
03/23/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1N8103 01 TX MEDICARE
421635001 05 TX
institution
Provider Business Practice Location Address Details
Address
630 S Fleishel Ave
City
State
Zip
75701-2041
Phone Number
903-606-5560
Fax Number
person
Provider Business Mailing Address Details
Address
630 S Fleishel Ave
City
State
Zip
75701-2041
Phone Number
903-606-5560
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Acute Care
Taxonomy
License No.
1032557 (Texas)
Definition
Definition to come...
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