Provider Demographics
NPI:1104185453
Name:FRANCIS, SHAWN M (CST, MBA)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:M
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:CST, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3062 PROVIDENCE OAK ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-3190
Mailing Address - Country:US
Mailing Address - Phone:832-998-9288
Mailing Address - Fax:
Practice Address - Street 1:3062 PROVIDENCE OAK ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-3190
Practice Address - Country:US
Practice Address - Phone:832-998-9288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-07
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747P1801X, 246ZX2200X
TX246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No246ZX2200XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherOrthopedic Assistant