| Organization Name: | SHANNON SPECIALTY CARE CLINIC |
| NPI Number: | 1073660221 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | IRVIN E. ZEITLER (CHAIRMAN OF BOARD) |
| Mailing Address: | 120 E Harris Ave San Angelo |
| State: | TX US |
| Postal Code: | 769035904 |
| Phone Number: | 3256575303 |
| Fax Number: | 3256588295 |
| NPI Enumeration Date: | 01/03/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
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Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204C00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine, Sports Medicine |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |