Mantooth, Shaun

Mantooth, Shaun is an individual health care provider with primary practice located at 6002 Slide Rd Ste D24 , Lubbock TX 79414-4310. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Mantooth, Shaun can be contacted via phone (806) 761-0450.

Contact Information

Primary practice address
6002 Slide Rd Ste D24 Lubbock TX 79414-4310
Phone: (806) 761-0450
Fax: (806) 796-7259
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA10211 Texas

Profile Details

NPI number 1326419748
LBN Legal business name Mantooth, Shaun
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2015
Last updated Oct 2nd, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326419748 NPPES
Texas Other 642529 TEMPORARY LIC NUMBER

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