Organization
BUCKAROOMEDIC
Active
Other names
Shannon F. Klump, DO
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANNON F KLUMP DO (PHYSICIAN/OWNER)
(346) 704-8766
Entity
Organization
Contact information
Practice address
1305 N MILAM ST, FREDERICKSBURG, TX 78624-2752
(830) 997-7626
Mailing address
1105 RUNNING BUCK LN, FREDERICKSBURG, TX 78624-2553
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
Q9405
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
362012201
—
TX
Enumeration date
07/25/2018
Last updated
07/25/2018
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