Individual provider Active NPI

Shawnee Wallace, DO

  • Pediatrics Physician
  • Houston, TX
National Provider Identifier
1861073694
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
V2321 Issued in TX
Practice address
6621 Fannin St
Houston, TX 77030-2399
Phone
(832) 824-1000
NPI assigned
Apr 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X V2321 TX Primary

Addresses

Primary practice location

6621 Fannin St
Houston, TX 77030-2399

Mailing address

1 Baylor PLZ
Houston, TX 77030-3411
Phone (713) 798-5928

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250611002308 TX Practitioner - Pediatric Medicine 9638689334 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hermann Hospital Based Physician Group CurrentSince Oct 1, 2025 Accepting new patients
Emergency Medicine Services of TX, PLLC CurrentSince Oct 1, 2025 Accepting new patients
Texas Children'S Physician Group Pediatrics CurrentSince May 27, 2025 Accepting new patients

Locations

225 E Parkwood Ave
Friendswood, TX 77546
Phone (281) 549-9400

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

6621 Fannin St
Houston, TX 77030
Phone (832) 824-1866

921 Gessner Rd
Houston, TX 77024
Phone (713) 242-3439

22430 Grand Corner Dr
#C1100
Katy, TX 77494

2555 Gulf Fwy S
#C1100
League City, TX 77573

101 W Expressway 83
McAllen, TX 78503
Phone (956) 661-9840

11100 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 770-7000

16100 South Fwy
Pearland, TX 77584
Phone (713) 413-5000

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

9250 Pinecroft Dr
#C
Shenandoah, TX 77380

17600 Interstate 45 S
The Woodlands, TX 77384
Phone (936) 267-5000

26306 Kuykendahl Rd
Tomball, TX 77375
Phone (346) 246-7700

6651 Main St
Va Hospital, TX 77030
Phone (832) 826-3000

1 Baylor Plz
Va Hospital, TX 77030
Phone (713) 798-5588

500 W Medical Center Blvd
Webster, TX 77598
Phone (713) 447-4650

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1861073694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BAYLOR PLZ",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303411",
            "telephone_number": "713-798-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302399",
            "telephone_number": "832-824-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "SHAWNEE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-14",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "V2321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.