Individual
SHAUN MICHAEL SHORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
960 CARIBOU DR, PROSPER, TX 75078-7066
(469) 343-6333
(855) 299-6441
Mailing address
960 CARIBOU DR, PROSPER, TX 75078-7066
(469) 343-6333
(855) 299-6441
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA04445
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8N9577
BCBS
TX
Enumeration date
07/19/2006
Last updated
09/12/2013
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