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Individual

DON SHANNON CALLENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
720 TRAVIS, LIBERTY, TX 77575-4828
(936) 336-6439
(936) 336-8870
Mailing address
720 TRAVIS, LIBERTY, TX 77575-4828
(936) 336-6439
(936) 336-8870

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M3952
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11818883
CAQH
TX
05
202747601
TX
01
8AW040
BC/BS
TX
01
8F0993
BC/BS
TX
01
M39952
LICENSE
TX
Enumeration date
04/19/2007
Last updated
09/04/2009
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