Provider Demographics
NPI:1245115138
Name:SHAYE WALSTON DO PLLC
Entity type:Organization
Organization Name:SHAYE WALSTON DO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAYE
Authorized Official - Middle Name:LYSETTE
Authorized Official - Last Name:WALSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:361-771-5257
Mailing Address - Street 1:4613 S STAPLES ST STE CANDD
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-2780
Mailing Address - Country:US
Mailing Address - Phone:361-851-0000
Mailing Address - Fax:
Practice Address - Street 1:4613 S STAPLES ST STE C&D
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-2780
Practice Address - Country:US
Practice Address - Phone:361-851-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty