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NPI Code Detail

MEDICARE: SHAWN MARK HENRY D.O.

MEDICARE:   SHAWN MARK HENRY  D.O.
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
1207X00000XOrthopaedic Surgery PhysicianL2316TX

General Provider Information

NPI Number : 1518901222
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAWN MARK HENRY D.O.
Provider Business Mailing Address
First Line : 533 S WHITE CHAPEL BLVD
Second Line :
City : SOUTHLAKE
State : TX
Zip : 76092-7316
Country : US
Telephone Number : 817-429-4545
Fax Number : 817-429-4547
Provider Business Practice Location Address
First Line : 3600 W 7TH ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-2534
Country : US
Telephone Number : 817-429-4545
Fax Number : 817-429-4547
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2006
Last Update Date : 05/30/2019

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Directions to “ SHAWN MARK HENRY D.O.” Practice Location

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