MEDICARE: SHANNON YVETTE GALES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175L00000X	Homeopath	SHANNON GALES	TX

General Provider Information

NPI Number	:	1043408297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON YVETTE GALES

Provider Business Mailing Address
First Line	:	2201 MAIN ST
Second Line	:	#830
City	:	DALLAS
State	:	TX
Zip	:	75201-4327
Country	:	US
Telephone Number	:	214-893-4882
Fax Number	:	866-544-3308

Provider Business Practice Location Address
First Line	:	2201 MAIN ST
Second Line	:	#830
City	:	DALLAS
State	:	TX
Zip	:	75201-4327
Country	:	US
Telephone Number	:	214-893-4882
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2007
Last Update Date	:	07/06/2011

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Directions to “ SHANNON YVETTE GALES ” Practice Location

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