Healthcare Provider Details

I. General information

NPI: 1093303406
Provider Name (Legal Business Name): BRITTANY SHANNON DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2021
Last Update Date: 01/02/2021
Certification Date: 01/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26406 OAK RIDGE DR STE 101
SPRING TX
77380-1965
US

IV. Provider business mailing address

46 S BETHANY BEND CIR
THE WOODLANDS TX
77382-1388
US

V. Phone/Fax

Practice location:
  • Phone: 832-813-8451
  • Fax:
Mailing address:
  • Phone: 214-356-4023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number14143
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: