Healthcare Provider Details

I. General information

NPI: 1497606438
Provider Name (Legal Business Name): SHANNON MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 W 11TH PL
BIG SPRING TX
79720-4114
US

IV. Provider business mailing address

PO BOX 1879 ATTN: ADMINISTRATION
SAN ANGELO TX
76902-1879
US

V. Phone/Fax

Practice location:
  • Phone: 432-263-1211
  • Fax:
Mailing address:
  • Phone: 325-657-5303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH WOOLDRIDGE
Title or Position: CFO
Credential:
Phone: 325-747-8212