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Organization
N H SHANNON MD PA
Active
Organization
N H SHANNON MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICK H SHANNON MD (PRESIDENT)
(210) 532-4555
Entity
Organization
Contact information
Practice address
3326 E SOUTHCROSS BLVD, SAN ANTONIO, TX 78223-1922
(210) 532-3216
(210) 532-6055
Mailing address
3326 E SOUTHCROSS BLVD, SAN ANTONIO, TX 78223-1922
(210) 532-3216
(210) 532-6055
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D2834
TX
207QG0300X
Geriatric Medicine (Family Medicine) Physician
D2834
TX
208D00000X
General Practice Physician
D2834
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092125601
—
TX
Enumeration date
12/02/2010
Last updated
12/02/2010
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