Individual
MRS. LORI KAYE SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
2802 VANZANDT CO.RD., #2685HOUSE NO., MABANK, TX 75147-2685
(903) 887-9773
(903) 887-1445
Mailing address
PO BOX 64, MABANK, TX 75147-0064
(903) 887-9773
(903) 887-1445
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
128408
TX
Other
Enumeration date
05/31/2007
Last updated
07/09/2007
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