Shannon Clinic Orthotics

LBN: Shannon Clinic
Shannon Clinic Orthotics is an health care organization with primary practice located at 120 E Beauregard Ave , San Angelo TX 76903-5919. The organization recently has only one registered license in Suppliers / Customized Equipment, which is considered as the primary health care specialty. Shannon Clinic can be contacted via phone (325) 653-9235, or through Villarreal, Ricardo via phone (325) 481-8248.

Contact Information

Primary practice address
120 E Beauregard Ave San Angelo TX 76903-5919
Phone: (325) 653-9235
Fax: (325) 653-9284
Website:
Map and Directions
Authorized official contact:
Name: Villarreal, Ricardo
Phone: (325) 481-8248

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Customized Equipment 332BC3200X 1210 Texas

Profile Details

NPI number 1285946913
LBN Legal business name Shannon Clinic
DBA Doing business as Shannon Clinic Orthotics
Authorized official Villarreal, Ricardo
Entity Organization
Organization subpart 1 No
Enumeration date Jul 10th, 2010
Last updated Jan 21st, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285946913 NPPES
Texas MEDICAID 1033840001

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