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Organization

SHINE MEDICAL OF TEXAS, P.A.

Active
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Organization

SHINE MEDICAL OF TEXAS, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATHERINE CASSIDY (CLINICAL OPERATIONS ASSOCIATE)
(856) 287-8167
Entity
Organization

Contact information

Practice address
2911 TURTLE CREEK BLVD STE 300, DALLAS, TX 75219-6243
(909) 442-0618
Mailing address
122 GRAND ST, NEW YORK, NY 10013-2614

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary

Other

Enumeration date
07/19/2022
Last updated
09/16/2022
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