Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | S9602 | TX |
NPI | 1548420631 |
---|---|
Provider Name | Jennifer A Shannon |
First Address | Plano, TX 75093-8336 |
Second Address | Plano, TX 75093-8336 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2008 |
Last Update Date | 17/09/2021 |