Anderson, Shane Blake
Anderson, Shane Blake is an sole proprietor health care provider with primary practice located at 3551 Roger Brooke Dr Brooke Army Medical Center, Fort Sam Houston TX 78234-4504. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Nuclear Medicine, Allopathic & Osteopathic Physicians / Nuclear Imaging & Therapy. Allopathic & Osteopathic Physicians / Nuclear Medicine is his primary health care specialty. Anderson, Shane Blake can be contacted via phone (210) 916-4062.Contact Information
Primary practice address
3551 Roger Brooke Dr Brooke Army Medical Center
Fort Sam Houston TX 78234-4504
Phone: (210) 916-4062
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 378 | Nebraska |
| Allopathic & Osteopathic Physicians / Nuclear Medicine | 207U00000X | 328507-1204 | Utah |
| Allopathic & Osteopathic Physicians / Nuclear Imaging & Therapy | 207UN0902X | 378 | Nebraska |
Profile Details
| NPI number | 1144208661 |
|---|---|
| LBN Legal business name | Anderson, Shane Blake |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 4th, 2006 |
| Last updated | Dec 19th, 2023 - about 2 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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