Individual
SHANE TIPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
6363 FOREST PARK ROAD 7TH FLOOR STE 749, DALLAS, TX 75390-4426
(214) 645-8500
(214) 645-3775
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(214) 645-0624
(214) 645-0078
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
675434
TX
Other
Enumeration date
10/10/2014
Last updated
07/21/2022
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