Active NPI
Shauna Marie Jimenez, LSA
- Surgery Physician
- Denton, TX
National Provider Identifier
1497266290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 178378
- Practice address
- 4001 Forest Bend Rd
Denton, TX 76208-2089 - Phone
- (469) 476-7342
- NPI assigned
- Oct 19, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 178378 | TX | Primary |
Addresses
Primary practice location
4001 Forest Bend Rd
Denton, TX 76208-2089
Mailing address
4001 Forest Bend Rd
Denton, TX 76208-2089
Phone (469) 476-7342
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178378 | TX | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716336000000",
"number": "1497266290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4001 FOREST BEND RD",
"city": "DENTON",
"state": "TX",
"postal_code": "762082089",
"telephone_number": "469-476-7342"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4001 FOREST BEND RD",
"city": "DENTON",
"state": "TX",
"postal_code": "762082089",
"telephone_number": "469-476-7342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIMENEZ",
"first_name": "SHAUNA",
"middle_name": "MARIE",
"credential": "LSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-19",
"last_updated": "2024-05-22",
"certification_date": "2024-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TX",
"license": "178378",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.