Individual
SHACOYA GWENNELL BRIGGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
35 12TH ST SE, PARIS, TX 75460-6006
(903) 401-8958
Mailing address
35 12TH ST SE, PARIS, TX 75460-6006
(903) 401-8958
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L058074
AR
Other
Enumeration date
10/07/2020
Last updated
10/07/2020
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