Individual
SHANNON PATRICK BUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
DO-55426
IA
207N00000X
Dermatology Physician
Primary
S0144
TX
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
DO-55426
IA
207ND0101X
MOHS-Micrographic Surgery Physician
S0144
TX
Other
Enumeration date
02/12/2010
Last updated
07/28/2026
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