Shannon Clinic
Organization Active NPI Durable Medical Equipment & Medical Supplies · San Angelo, TX
NPI 1124038633 · NPPES record last updated Jan 21, 2020
Key facts
- NPI
- 1124038633
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- Legal business name
- SHANNON CLINIC
- Practice address
- 120 E Beauregard Ave
San Angelo, TX 76903-5919 - Phone
- (325) 658-1511
- NPI assigned
- Aug 8, 2006
- Organization subpart
- No
Authorized official
- Name
- Ricardo Villarreal
- Title
- Cao
- Phone
- (325) 481-8248
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 6
Practitioners 549
-
Eva Mariquit Beniga Abarquez, APRN, FNP-C
-
Stuart Lee Abramson, M.D.
-
Laura M Adams, MD
-
Bambi Lucia Aker, LCSW
-
Melissa Aleta, MD
-
Saint-Martin Allihien, MD, MPH
-
Steven Alred, M.D.
-
Sandeep Amesur, M.D.
-
Greg W Anderson, FNP
-
Milo Anderson, DPM
-
Carl D. Anderton, M.D.
-
Bryan Neil Angle, MD
-
Edward J Artnak, MD
-
Annelise Arze, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930078185 | TX | DME Supplier - Multi-Specialty - Physician |
0840103727 | Practice locations: San Angelo, TX |
National Provider Directory
- Tax ID family
- Shannon Clinic Reference Lab
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Yes |
Addresses
Primary practice location
120 E Beauregard Ave
San Angelo, TX 76903-5919
Mailing address
PO Box 22000
San Angelo, TX 76902-7200
Phone (325) 658-1511
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033840001 | Other | TX | DME PTAN |
Other names
- DMEPOS
Other providers in San Angelo, TX
- Lauren Cary Shaffer
- Soroush Shahrokh
- Moulali Shaik
- Shannon Business Services, Inc.
- Shannon Business Services, Inc.
- Shannon Clinic
- Shannon Clinic
- Shannon Clinic
- Shannon Clinic
- Shannon Clinic Reference Lab
All providers in San Angelo, TX · Durable Medical Equipment & Medical Supplies in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 21, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.