SHANNON CLINIC RP (NPI# 1285818849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285818849 |
| Entity Type | Organization |
| Organization Name | SHANNON CLINIC RP |
| Practice Address |
120 E Beauregard Ave San Angelo TX 76903-5919 |
| Mailing Address |
Po Box 90259 San Angelo TX 76902-8059 |
| Practice Telephone | 3256581511 |
| Mailing Telephone | 3256581511 |
| Mailing Fax Number | 3256590180 |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2020-01-21 |
| Authorized Official Name | RICARDO VILLARREAL (CAO) |
| Authorized Official Telephone | 3254818248 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ZP0101X |
Pathology Specialization: Anatomic Pathology |
Allopathic & Osteopathic Physicians | ||
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS GROUP | 0057QQ | 01 |
| Street Address |
120 E BEAUREGARD AVE |
| City | SAN ANGELO |
| State | TX |
| Zip Code | 76903-5919 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114921459 | Ernest Charlesworth | Dermatology | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2005-06-01 |
| 1093349359 | Michael T Mcenrue | Nurse Practitioner | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2020-02-26 |
| 1194298596 | Rachel J Reyes | Nurse Practitioner | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2019-01-08 |
| 1649746512 | Jessica Orona | Nurse Practitioner | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2018-10-18 |
| 1770960312 | Dawn Empey | Registered Nurse | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2015-05-04 |
| 1639573231 | Eduardo Jose Gonzalez | Internal Medicine | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2014-10-10 |
| 1043626518 | Emily Michelle Dodd | Anesthesiology | 120 E Beauregard Ave, San Angelo, TX 76903 | 2014-07-06 |
| 1487080479 | Melissa P Hohensee | Nurse Practitioner | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2013-09-23 |
| 1003168055 | Maegin M Carlile | Nurse Practitioner | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2012-10-15 |
| 1760746325 | Kristi D. Urias | Anesthesiology | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2012-06-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306386081 | The Waterford Wellness Spa | Clinic/Center | 602 S. Abe, San Angelo, TX 76903 | 2017-03-01 |
| 1154782415 | Jerrica Elayne Escobedo | Counselor | 424 South Oakes, San Angelo, TX 76903 | 2016-03-15 |
| 1578923868 | Wal-mart Stores Texas, LLC | Technician/Technologist | 3440 S. Bryant Blvd, San Angelo, TX 76903 | 2016-02-29 |
| 1821475161 | San Angelo Dental, Pllc | Dentist | 614 29th Street, Suite, Sanangelo, TX 76903 | 2015-05-06 |
| 1033549670 | Tina Faye Luck | Nurse Practitioner | 36 E Twohig Ave Ste 1100, San Angelo, TX 76903 | 2013-11-18 |
| 1295087294 | Tara Joiner | Counselor | 27 W Beauregard Ave, San Angelo, TX 76903 | 2012-10-15 |
| 1225380728 | Tanya L Favor | Physician Assistant | 215 E. College, San Angelo, TX 76903 | 2012-10-08 |
| 1336459551 | Education Service Center | Social Worker | 612 S Irene, San Angelo, TX 76903 | 2010-10-21 |
| 1508194176 | Pay and Save Inc | Pharmacy | 1926 N. Bryant Blvd., San Angelo, TX 76903 | 2009-11-19 |
| 1326375734 | Pay and Save Inc | Pharmacy | 2 S. Main St., San Angelo, TX 76903 | 2009-11-05 |
| Find all providers in zip 76903 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023586534 | Curewell Diagnostic Services LLC | Radiology | 202 W Twohig Ave Ste 203, San Angelo, TX 76903-6430 | 2018-11-02 |
| 1881850436 | Daniel Burgess Lankford | Radiology | 3308 Foster St, San Angelo, TX 76903-9314 | 2008-08-04 |
| 1932380136 | Ross A. Harper | Radiology | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2007-11-16 |
| 1114934452 | Kenneth Anderson Taylor | Radiology | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2006-08-01 |
| 1194785022 | John E Alexander | Radiology | 3308 Foster St, San Angelo, TX 76903-9314 | 2006-03-24 |
| 1942260898 | Edward H Snyder | Radiology | 3308 Foster St, San Angelo, TX 76903-9314 | 2006-03-24 |
| 1841278397 | Michelle G Snuggs | Radiology | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2006-01-05 |
| 1124006945 | Michael G Sickels | Radiology | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2006-01-03 |
| 1114904240 | Eddie G Shell II | Radiology | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2005-12-29 |
| 1528045788 | Victor E Schulze IIi | Radiology | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2005-12-29 |
| Find all providers in SAN ANGELO | ||||
| City | SAN ANGELO |
| Zip Code | 76903 |
Please comment or provide details below to improve the information on SHANNON CLINIC RP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.