Organization · Type 2 NPI
Shady Oaks Clinic PLLC
Family Nurse Practitioner · Runaway Bay, TX
NPI number
1245153493
Active
Practice location
204 Shady Oaks Dr
Runaway Bay, TX 76426-9462
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | None listed |
Family Nurse Practitioner: Definition to come...
About NPI 1245153493
Shady Oaks Clinic PLLC's National Provider Identifier is 1245153493, issued on Aug 4, 2026. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Runaway Bay, TX. The record was last updated on Aug 4, 2026.