Individual
CHRISTIE PEER SHANAFELT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
855 MONTGOMERY, FORT WORTH, TX 76107-2553
(817) 920-7340
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Q5928
TX
207Q00000X
Family Medicine Physician
274855
NY
207Q00000X
Family Medicine Physician
Primary
Q5928
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
350236101
—
TX
01
—
8FM865
BCBS
TX
Enumeration date
09/17/2012
Last updated
12/04/2015
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