Individual
DR. SHANNON LEIGH AMONETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
815 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2224
(817) 321-0312
(817) 317-7033
Mailing address
816 W CANNON ST, FORT WORTH, TX 76104-3146
(817) 321-0312
(817) 317-7033
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
M1468
TX
2085R0202X
Diagnostic Radiology Physician
Primary
M1468
TX
2085U0001X
Diagnostic Ultrasound Physician
M1468
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1768848-05
—
TX
05
—
176884801
—
TX
Enumeration date
06/06/2006
Last updated
08/15/2012
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