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Individual

MS. SHANNON R MAHONEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7208
(214) 645-4673
(214) 645-2615
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(214) 645-4673
(214) 645-2615

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
085002384
IL
363AM0700X
Medical Physician Assistant
Primary
PA07353
TX

Other

Enumeration date
09/16/2005
Last updated
12/20/2016
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