Individual provider · Type 1 NPI

Shelby Odell Church Jr., PA-C

Medical Physician Assistant · Beaumont, TX

NPI number 1942365564 Active

Practice location

6450 Folsom Dr, Beaumont Family Practice Associates
Beaumont, TX 77706-7269

Call (409) 835-0524 Map

Fax (409) 833-2058

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA01919 (TX)

Medical Physician Assistant: Definition to come...

10 other providers at this address

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About NPI 1942365564

Shelby Odell Church Jr., PA-C's National Provider Identifier is 1942365564, issued on Dec 26, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Beaumont, TX. The record was last updated on Sep 7, 2022.