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General NPI Number Information
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NPI Number | 1023131695
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Entity Type | Organization
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Legal Business Name | SHANAN CHIROPRACTIC
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 03/17/2008
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Provider Practice Location Address
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Address Line | 5840 BALCONES DR STE 100
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City | AUSTIN
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State | TX
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Zip | 78731-4246
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Country | US
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Telephone | 512-452-9469
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Fax | 512-452-4983
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Provider Business Mailing Address
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Address Line | 5840 BALCONES DR STE 100
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City | AUSTIN
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State | TX
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Zip | 78731-4246
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Country | US
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Telephone | 512-452-9469
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Fax | 512-452-4983
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Authorized Official
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Title or Position | GEORGE M. SHANNAN,D.C.
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Name | GEORGE MARTIN SHANNAN
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Credential | CHIROPACTOR
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Telephone | 512-452-9469
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2086
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 7335
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License Number State | TX
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