Individual
GEORGE MARK SHANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5840 BALCONES DR STE 100, AUSTIN, TX 78731-4246
(512) 452-9469
(512) 452-7283
Mailing address
4709 LOOKOUT MOUNTAIN CV, AUSTIN, TX 78731-3654
(512) 452-9469
(512) 452-7283
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7335
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85952G
BLUECROSS
TX
Enumeration date
08/19/2006
Last updated
03/06/2008
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