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General NPI Number Information
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NPI Number | 1962530865
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Entity Type | Individual
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Provider Name | MARY SHANNON MCCORD CPNP
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Gender | Female
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6621 FANNIN ST # MC1-1410
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City | HOUSTON
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State | TX
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Zip | 77030-2303
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Country | US
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Telephone | 832-826-5208
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Fax |
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Provider Business Mailing Address
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Address Line | 14750 CINDYWOOD DR
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City | HOUSTON
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State | TX
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Zip | 77079-6410
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Country | US
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Telephone | 281-497-4478
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Fax |
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 522615
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License Number State | TX
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