Most Relevant Information
Provider Data
| NPI Number: | 1003508847 |
| Provider Name: | MONICA ELLIS VAN SHUFFLIN MD |
| Entity Type: | Individual |
| Taxonomy Code: | 171000000X |
| Specialty: | Military Health Care Provider |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/22/2023 |
| Last Updated: | 05/31/2023 |
Provider Practice Location
4502 MEDICAL DR
SAN ANTONIO
TX
782294402
Practice Location Phone/Fax
| Phone: | 8159013745 |
| Fax: |
Provider Mailing Location
300 E BASSE RD APT 2109
SAN ANTONIO
TX
782098395
Provider Mailing Phone/Fax
| Phone: | 8159013745 |
| Fax: |