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Individual

DR. DONNA ARLENE SHANNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
345 N HIGHWAY 67, CEDAR HILL, TX 75104-2134
(972) 956-5300
(972) 956-5393
Mailing address
PO BOX 9101, COPPELL, TX 75019-9494
(972) 745-7500
(972) 471-0700

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L1743
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
164476701
MEDICAID FOR DALLAS COUNTY
TX
05
164476702
TX
01
8B5494
MEDICARE FOR DALLAS COUNTY
TX
01
8K2772
BC/BS
TX
Enumeration date
02/15/2006
Last updated
04/06/2016
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