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General NPI Number Information
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NPI Number | 1932135993
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Entity Type | Individual
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Provider Name | SHAWN M HARKRIDER HIS
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Gender | Female
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 04/27/2011
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Provider Practice Location Address
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Address Line | 9500 RAY WHITE RD SUITE 200
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City | FORT WORTH
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State | TX
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Zip | 76244-9104
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Country | US
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Telephone | 817-745-4572
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Fax | 817-764-6282
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Provider Business Mailing Address
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Address Line | 561 DOVE CREEK CIR
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City | GRAPEVINE
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State | TX
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Zip | 76051-3166
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Country | US
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Telephone | 817-657-8647
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Fax | 817-764-6282
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 50699
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License Number State | TX
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