MEDICARE: SHAWNA MCLAUGHLIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	3132487	TX

General Provider Information

NPI Number	:	1053171991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWNA MCLAUGHLIN

Provider Business Mailing Address
First Line	:	11215 S INTERSTATE 35 STE 102
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78747-1864
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11215 S INTERSTATE 35
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78747-1863
Country	:	US
Telephone Number	:	512-292-1908
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2024
Last Update Date	:	03/19/2024

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Directions to “ SHAWNA MCLAUGHLIN ” Practice Location

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