Individual
SHANNA BURRIS MEADS
Active
Individual
SHANNA BURRIS MEADS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
M0820
TX
207ND0101X
MOHS-Micrographic Surgery Physician
M0820
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
173749601
—
TX
01
—
8A2684
BLUE CROSS AND BLUE SHIELD
TX
01
—
P00228994
RAILROAD MEDICARE PTAN
TX
Enumeration date
06/21/2006
Last updated
05/22/2008
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