Meads, Shanna Burris

Meads, Shanna Burris is an individual health care provider with primary practice located at 1367 Dominion Plz , Tyler TX 75703-1013. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / Dermatology is her primary health care specialty. Meads, Shanna Burris can be contacted via phone (903) 534-6200.

Contact Information

Primary practice address
1367 Dominion Plz Tyler TX 75703-1013
Phone: (903) 534-6200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X M0820 Texas
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X M0820 Texas

Profile Details

NPI number 1023054624
LBN Legal business name Meads, Shanna Burris
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2006
Last updated May 22nd, 2008 - about 16 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 1023054624 NPPES
Texas MEDICAID 173749601
Texas Other P00228994
Texas Other 8A2684

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