Shannon Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SHANNON CLINIC

Practice address

120 E Beauregard Ave
San Angelo, TX 76903-5919

Phone

(325) 658-1511

Fax

(325) 481-2166

NPI assigned

Jun 13, 2005

Last updated

Jul 14, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ricardo Villarreal

Title

Coo

Phone

(325) 747-2200

Specialties & licenses 15

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in TX, HI, NC, VA, SC, OH, MS, CO, WA, NV, OR, MA, MD, PA, ID, KS, FL, CA, IL, GA, MI, UT22 enrollments

Enrollment records 22

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Shannon Clinic

  dba Dmepos

  • Durable Medical Equipment & Medical Supplies
  • San Angelo, TX
  • NPI 1124038633

  0840103727

  Same PAC ID
• Shannon Clinic

  • Rural Health Clinic/Center
  • Ozona, TX
  • NPI 1245230465

  0840103727

  Same PAC ID

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Shannon Clinic

  • Rural Health Clinic/Center
  • Sweetwater, TX
  • NPI 1093051401

  O20031222000702

  Same enrollment
• Shannon Clinic

  • Rural Health Clinic/Center
  • Ozona, TX
  • NPI 1245230465

  O20031222000702

  Same enrollment
• Shannon Clinic

  dba Vista Verde Medical Plaza

  • Pediatrics Physician
  • Del Rio, TX
  • NPI 1790986719

  O20031222000702

  Same enrollment

Locations

Practitioners 727

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eva Mariquit Beniga Abarquez, APRN, FNP-C

  • Family Nurse Practitioner
  • San Angelo, TX
  • NPI 1689457657
  Medicare reassignment Care Compare group NPD
• Stuart Lee Abramson, M.D.

  • Allergy Physician
  • San Angelo, TX
  • NPI 1710984893
  Medicare reassignment Care Compare group NPD
• Abner Jorge Acevedo-Peon, M.D

  • Internal Medicine Physician
  • San Angelo, TX
  • NPI 1619200607
  Medicare reassignment Care Compare group NPD
• Laura M Adams, MD

  • Obstetrics & Gynecology Physician
  • San Angelo, TX
  • NPI 1871575951
  Medicare reassignment Care Compare group NPD
• Caesasonia Pascual Agatep, NP

  • Nurse Practitioner
  • San Angelo, TX
  • NPI 1154748671
  Medicare reassignment Care Compare group NPD
• Bambi Lucia Aker, LCSW

  • Clinical Social Worker
  • San Angelo, TX
  • NPI 1730908328
  Medicare reassignment Care Compare group NPD
• James Richard Alaly, MD

  • Diagnostic Radiology Physician
  • San Angelo, TX
  • NPI 1669616421
  Medicare reassignment Care Compare group NPD
• Fernando Alcocer-Aguilar, MD

  • Internal Medicine Physician
  • San Angelo, TX
  • NPI 1043508716
  Medicare reassignment Care Compare group NPD
• Melissa Aleta, MD

  • Nephrology Physician
  • San Angelo, TX
  • NPI 1255696522
  Medicare reassignment Care Compare group NPD
• Robert W Alexander, MD

  • Orthopaedic Surgery Physician
  • San Angelo, TX
  • NPI 1558330159
  Medicare reassignment Care Compare group NPD
• Saint-Martin Allihien, MD, MPH

  • Internal Medicine Physician
  • San Angelo, TX
  • NPI 1467194498
  Medicare reassignment Care Compare group NPD
• Anna Marie Allred

  • Anesthesiology Physician
  • Houston, TX
  • NPI 1639378920
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752451200000",
    "number": "1770587149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22000",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769027200",
            "telephone_number": "325-658-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E BEAUREGARD AVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769035919",
            "telephone_number": "325-658-1511",
            "fax_number": "325-481-2166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-13",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A",
        "authorized_official_last_name": "VILLARREAL",
        "authorized_official_first_name": "RICARDO",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "325-747-2200"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127005001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "00T83Z",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "127005002",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CL8387",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Business Services, Inc. (Shannon Pharmacy)
• Shannon Clinic (Dmepos)
• Shannon Clinic (Shannon Clinic Orthotics)
• Shannon Clinic (Shannon Clinic Orthotics)
• Shannon Clinic
• Shannon Clinic Reference Lab
• Shannon Clinic RP
• Shannon Joint Ventures, Inc (Shannon Dialysis Center)
• Shannon Medical Center
• Shannon Medical Center

• Family Medicine Physician in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.