Organization
SHANNON SENIOR HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRVIN ZIETLER M.D. (PHYSICIAN)
(325) 949-9408
Entity
Organization
Contact information
Practice address
3016 VISTA DEL ARROYO DR, SAN ANGELO, TX 76904-6146
(325) 949-9408
Mailing address
3016 VISTA DEL ARROYO DR, SAN ANGELO, TX 76904-6146
(325) 949-9408
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
F4722
TX
Other
Enumeration date
05/23/2007
Last updated
08/22/2020
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