Individual
SHANE MALONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
REPT, CNIM
Contact information
Practice address
1356 OLD CREEK DR, TYLER, TX 75703-7642
(903) 534-0809
(903) 939-9149
Mailing address
1356 OLD CREEK DR, TYLER, TX 75703-7642
(903) 534-0809
Taxonomy
Speciality
Code
Description
License number
State
246ZE0500X
EEG Specialist/Technologist
—
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
2580
TX
246ZS0410X
Surgical Technologist
—
—
Other
Enumeration date
05/08/2019
Last updated
05/08/2019
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