| Doctor Name: | DR. WILLIAM ROBERT SHEPPARD |
| NPI Number: | 1780616771 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MAMFC |
| License Number: | 11769 |
| Business Practice Address: | 1555 Merrimac Circle Suite 105 Ft. Worth, TX - 76107 |
| Business Phone Number: | 8178100030 |
| Business Fax Number: | 8178773562 |
| Mailing Address: | 1555 Merrimac Circle, Suite 105 FT. WORTH |
| State: | TX |
| Postal Code: | 76107 |
| Phone Number: | 8178100030 |
| Fax Number: | 8178773562 |
| NPI Enumeration Date: | 07/07/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 11769 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |