Smith, Shannon L

Smith, Shannon L is an individual health care provider with primary practice located at 3302 Ne Stallings Dr , Nacogdoches TX 75965-8727. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Smith, Shannon L can be contacted via phone (936) 564-3600.

Contact Information

Primary practice address
3302 Ne Stallings Dr Nacogdoches TX 75965-8727
Phone: (936) 564-3600
Fax: (936) 564-3770
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X H2797 Texas

Profile Details

NPI number 1598876237
LBN Legal business name Smith, Shannon L
Credentials MD FACS
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated May 12th, 2008 - about 18 years ago

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 1598876237 NPPES
Texas Other 8BB470 BCBS
Texas MEDICAID 127607302 BCBS
Texas Other 00Y956 BCBS
Texas Other 8F7718 BCBS

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