Amonette, Shannon Leigh

Amonette, Shannon Leigh is an individual health care provider with primary practice located at 815 Pennsylvania Ave , Fort Worth TX 76104-2224. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Diagnostic Ultrasound. Allopathic & Osteopathic Physicians / Diagnostic Radiology is her primary health care specialty. Amonette, Shannon Leigh can be contacted via phone (817) 321-0312.

Contact Information

Primary practice address
815 Pennsylvania Ave Fort Worth TX 76104-2224
Phone: (817) 321-0312
Fax: (817) 317-7033
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X M1468 Texas
Allopathic & Osteopathic Physicians / Body Imaging 2085B0100X M1468 Texas
Allopathic & Osteopathic Physicians / Diagnostic Ultrasound 2085U0001X M1468 Texas

Profile Details

NPI number 1871532465
LBN Legal business name Amonette, Shannon Leigh
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2006
Last updated Aug 15th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871532465 NPPES
Texas MEDICAID 1768848-05
Texas MEDICAID 176884801

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