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Individual

SHANNON ROBERTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2307 OAK LN STE 120, GRAND PRAIRIE, TX 75051-4885
(469) 999-5934
Mailing address
2307 OAK LN STE 120, GRAND PRAIRIE, TX 75051-4885
(469) 999-5934

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary

Other

Enumeration date
04/22/2024
Last updated
04/24/2024
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