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General NPI Number Information
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NPI Number | 1639568405
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Entity Type | Individual
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Provider Name | SHEA STARK DC
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Gender | Female
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Dates
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Enumeration Date | 01/16/2015
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 8500 CYPRESSWOOD DR STE 207
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City | SPRING
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State | TX
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Zip | 77379-7109
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Country | US
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Telephone | 281-547-8930
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Fax | 844-473-1290
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Provider Business Mailing Address
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Address Line | 8500 CYPRESSWOOD DR STE 207
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City | SPRING
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State | TX
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Zip | 77379-7109
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Country | US
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Telephone | 281-547-8930
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Fax | 844-473-1290
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHI-CHI-LIC-3454
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License Number State | MT
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