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General NPI Number Information
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NPI Number | 1982825329
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Entity Type | Individual
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Provider Name | STANLEY DEAN SHAWN RPH
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Gender | Male
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1201 S STOCKTON AVE
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City | MONAHANS
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State | TX
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Zip | 79756-6032
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Country | US
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Telephone | 432-943-4445
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Fax | 432-943-4464
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Provider Business Mailing Address
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Address Line | 1303 E 15TH ST
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City | MONAHANS
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State | TX
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Zip | 79756-6326
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Country | US
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Telephone | 432-943-8560
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Fax | 432-943-4464
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 21076
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License Number State | TX
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