MEDICARE: SHANNON GARITTY MD

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	207LP2900X	Pain Medicine (Anesthesiology) Physician	S2039	TX
2	208VP0014X	Interventional Pain Medicine Physician	S2039	TX
3	207L00000X	Anesthesiology Physician	S2039	TX

General Provider Information

NPI Number	:	1629414065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON GARITTY MD

Provider Business Mailing Address
First Line	:	PO BOX 610344
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75261-0344
Country	:	US
Telephone Number	:	254-245-9177
Fax Number	:	254-245-9178

Provider Business Practice Location Address
First Line	:	205 WOODHEW DR STE 220
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76712-6679
Country	:	US
Telephone Number	:	254-245-9175
Fax Number	:

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

Provider Enumeration Date	:	05/13/2013
Last Update Date	:	12/09/2025

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Directions to “ SHANNON GARITTY MD” Practice Location

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