Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JACKY DWAYNE SHANNON, M.D.
Active Sole ProprietorDR. JACKY DWAYNE SHANNON, M.D. is a Critical Care Medicine (Anesthesiology) healthcare provider located in LUBBOCK, Texas. NPI 1265510218 is currently active in the NPPES registry. Verify at CMS.
Critical Care Medicine (Anesthesiology) · LUBBOCK, TX
Registration Details
- NPI Number
- 1265510218
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 1, 2006 (19.740620653174 yrs)
- Last Updated
- Nov 30, 2012
- Licenses
-
L8505 (TX)L8505 (TX)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3601 4TH STLUBBOCK, TX, 794300002Browse TX providers · Browse ZIP 79430
- Phone
- 8067432981
- Primary Specialty
-
Critical Care Medicine (Anesthesiology)
207LC0200X
- Additional Specialty
- Critical Care Medicine (Anesthesiology)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.