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General NPI Number Information
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NPI Number | 1568774834
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Entity Type | Individual
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Provider Name | SHANNON SEANA RICKNER-SCHMIDT MD
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Gender | Female
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Dates
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Enumeration Date | 07/02/2010
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Last Update Date | 09/16/2014
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Provider Practice Location Address
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Address Line | 5323 HARRY HINES BLVD
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City | DALLAS
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State | TX
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Zip | 75390-7208
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Country | US
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Telephone | 214-648-3916
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Fax | 214-648-8423
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Provider Business Mailing Address
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Address Line | PO BOX 845347
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City | DALLAS
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State | TX
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Zip | 75284-5347
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Country | US
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Telephone | 214-648-3916
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Fax | 214-648-8423
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | MT198330
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | Q0551
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License Number State | TX
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