| Doctor Name: | TERESA SHOOK |
| NPI Number: | 1063632297 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LSA |
| License Number: | SA00146 |
| Business Practice Address: | 4401 Booth Calloway Rd North Richland Hills, TX - 761807371 |
| Business Phone Number: | 8172551000 |
| Business Fax Number: | |
| Mailing Address: | Po Box 295305, LEWISVILLE |
| State: | TX |
| Postal Code: | 750295305 |
| Phone Number: | 8179077650 |
| Fax Number: | 8176563392 |
| NPI Enumeration Date: | 04/30/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | SA00146 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |