Provider Demographics
NPI:1609672625
Name:TATE, SHELBY LEIGH (DC, MS)
Entity type:Individual
Prefix:DR
First Name:SHELBY
Middle Name:LEIGH
Last Name:TATE
Suffix:
Gender:F
Credentials:DC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9206 FM 1101
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-0208
Mailing Address - Country:US
Mailing Address - Phone:830-708-8144
Mailing Address - Fax:
Practice Address - Street 1:1924 MT GALLANT RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-9434
Practice Address - Country:US
Practice Address - Phone:803-323-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-20
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5226111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor