Organization
SHANNON CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY GIBIAN (EXECUTIVE DIRECTOR)
(325) 658-1511
Entity
Organization
Contact information
Practice address
201 E ARIZONA AVE, SWEETWATER, TX 79556-7119
(325) 235-8641
(325) 235-5925
Mailing address
PO BOX 3348, SAN ANGELO, TX 76902-3348
(325) 658-1511
(325) 659-0180
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
12/13/2012
Last updated
12/13/2012
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