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NPI Code Detail

MEDICARE: N H SHANNON MD PA

MEDICARE: N H SHANNON MD PA
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
1208D00000XGeneral Practice PhysicianD2834TX
2207QG0300XGeriatric Medicine (Family Medicine) PhysicianD2834TX
3207Q00000XFamily Medicine PhysicianD2834TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386946903
Entity Type Code : Organization
Provider Name (Legal Business Name) : N H SHANNON MD PA
Provider Business Mailing Address
First Line : 3326 E SOUTHCROSS BLVD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78223-1922
Country : US
Telephone Number : 210-532-3216
Fax Number : 210-532-6055
Provider Business Practice Location Address
First Line : 3326 E SOUTHCROSS BLVD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78223-1922
Country : US
Telephone Number : 210-532-3216
Fax Number : 210-532-6055
Authorized Official
Title or Position : PRESIDENT
Name : DR. NICK H SHANNON
Credential : MD
Telephone Number : 210-532-4555
Provider Enumeration Date : 12/02/2010
Last Update Date : 12/02/2010

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Directions to “N H SHANNON MD PA ” Practice Location

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