Individual
SHAWN C. NESSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
12709 TOEPPERWEIN RD STE 302, LIVE OAK, TX 78233-3260
(210) 653-9307
(210) 653-7014
Mailing address
1701 W CHARLESTON BLVD, #215, LAS VEGAS, NV 89102-2325
(702) 671-2395
(702) 382-5388
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
S7106
TX
2086S0102X
Surgical Critical Care Physician
Primary
S7106
TX
2086S0127X
Trauma Surgery Physician
S7106
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
417623201
—
TX
01
—
P02587370
MCRR
TX
Enumeration date
05/01/2006
Last updated
04/20/2023
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