Shannon Elizabeth Blalock
Pediatric Cardiologist
5323 Harry Hines Boulevard
Dallas
, Texas 75390-7208
Shannon Elizabeth Blalock
Pediatric Cardiologist
5323 Harry Hines Boulevard
Dallas
, Texas 75390-7208
(214) 456-6154
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About
Features
Specialties
- Pediatric Cardiologist
Languages spoken
- English
Location
First Address
- Shannon Elizabeth Blalock
- P.o. Box 845347
- Dallas, TX
- Zip : 75284-5347
- Fax : (214) 456-6154
- Phone : (214) 456-2333
Second Address
- Shannon Elizabeth Blalock
- 5323 Harry Hines Boulevard
- Dallas, TX
- Zip : 75390-7208
- Fax : (214) 456-6154
- Phone : (214) 456-2333
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080P0202X | Pediatric Cardiologist | M1519 | TX |
National Provider Identifier
| NPI | 1285825505 |
|---|---|
| Provider Name | Shannon Elizabeth Blalock |
| First Address | Dallas, TX 75284-5347 |
| Second Address | Dallas, TX 75390-7208 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/08/2007 |
| Last Update Date | 15/08/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 204311905 | (05) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.