SHANNON CLINIC (NPI# 1285946913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285946913 |
| Entity Type | Organization |
| Organization Name | SHANNON CLINIC |
| Other Organization Name | SHANNON CLINIC ORTHOTICS |
| Practice Address |
120 E Beauregard Ave San Angelo TX 76903-5919 |
| Mailing Address |
Po Box 22000 San Angelo TX 76902-7200 |
| Practice Telephone | 3256539235 |
| Practice Fax Number | 3256539284 |
| Mailing Telephone | 3256581511 |
| Mailing Fax Number | 3254812165 |
| Enumeration Date | 2010-07-10 |
| 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 |
|---|---|---|---|---|---|
| Y | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
1210 | TX | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 1033840001 | 05 |
| Other Name | Type Code |
|---|---|
| SHANNON CLINIC ORTHOTICS | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245230465 | Shannon Clinic | Clinic/Center | 102 North Avenue H, Ozona, TX 76943-0907 | 2005-07-29 |
| 1356752307 | Shannon Clinic | Prosthetic/Orthotic Supplier | 110 E Twohig Ave, San Angelo, TX 76903-5916 | 2014-05-13 |
| 1093051401 | Shannon Clinic | Clinic/Center | 201 E Arizona Ave, Sweetwater, TX 79556-7119 | 2012-12-13 |
| 1285954396 | Shannon Clinic | Prosthetic/Orthotic Supplier | 110 E Twohig Ave, San Angelo, TX 76903-5916 | 2010-06-11 |
| 1790986719 | Shannon Clinic | Family Medicine | 1801 N Bedell Ave, Del Rio, TX 78840-8001 | 2007-05-29 |
| 1124038633 | Shannon Clinic | Durable Medical Equipment & Medical Supplies | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2006-08-08 |
| 1770587149 | Shannon Clinic | Allergy & Immunology | 120 E Beauregard Ave, San Angelo, TX 76903-5919 | 2005-06-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SHANNON CLINIC | 120 E Beauregard Ave, San Angelo, TX 76903-5919 |
| 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 | ||||
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|---|---|---|---|---|
| 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 | 332BC3200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Customized Equipment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609054501 | Lifestyle Medical, LLC | Durable Medical Equipment & Medical Supplies | 2205 W Beauregard Ave, San Angelo, TX 76901-3701 | 2008-02-04 |
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| 1649896119 | Evolve Medical Supply & Equipment, LLC | Durable Medical Equipment & Medical Supplies | 4953 N. O'connor Rd., Suite 150, Irving, TX 75062 | 2020-06-22 |
| 1639794621 | Allen E Navey Dds Pa | Durable Medical Equipment & Medical Supplies | 405 W Gramercy Pl, San Antonio, TX 78212-2827 | 2020-06-15 |
| 1790309383 | Krishe Inc | Durable Medical Equipment & Medical Supplies | 7777 Warren Pkwy Ste 280, Frisco, TX 75034-8129 | 2020-05-30 |
| 1740800176 | Dme-now, LLC | Durable Medical Equipment & Medical Supplies | 734 S Saginaw Blvd, Saginaw, TX 76179-2109 | 2020-04-27 |
| 1336778737 | Paulette Sanford Dds, Pllc | Durable Medical Equipment & Medical Supplies | 4221 Benner Ste 200, Kyle, TX 78640-2221 | 2020-04-07 |
| 1962040303 | Sleep Better Austin Treatment Pllc | Durable Medical Equipment & Medical Supplies | 1600 W 38th St Ste 407, Austin, TX 78731-6407 | 2019-12-17 |
| Find all providers with the same taxonomy | ||||
| City | SAN ANGELO |
| Zip Code | 76903 |
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| 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.