Individual
SHANNON WAYNE CADDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
181 PRIVATE ROAD 3454, PARADISE, TX 76073-2447
(682) 225-1975
Mailing address
805 N WHITTINGTON PKWY, LOUISVILLE, KY 40222-7101
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
Primary
37247
TX
Other
Enumeration date
02/11/2021
Last updated
02/11/2021
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