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Organization
SHANNON CLINIC
Active
Organization
SHANNON CLINIC
Active
Other names
VISTA VERDE MEDICAL PLAZA
Organization subpart
No
Provider details
NPI number
Authorized official
GARY BOWEN (CHIEF OPERATIONS OFFICER)
(325) 658-1511
Entity
Organization
Contact information
Practice address
1801 N BEDELL AVE, DEL RIO, TX 78840-8001
(830) 768-9200
Mailing address
PO BOX 90201, SAN ANGELO, TX 76902-8001
(325) 658-1511
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
TX
Other
Enumeration date
05/29/2007
Last updated
09/11/2025
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