Individual
SHANE LALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSFA
Contact information
Practice address
7601 CHURCHILL WAY APT 1639, DALLAS, TX 75251-1945
(214) 227-2457
(214) 764-0880
Mailing address
PO BOX 2550, ROWLETT, TX 75030-2550
(214) 227-2457
(214) 764-0880
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
150397
TX
Other
Enumeration date
06/20/2024
Last updated
06/20/2024
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