Provider Demographics
NPI:1184185456
Name:WALKER, SHAWN JEFFREY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:JEFFREY
Last Name:WALKER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10303 INDIANA AVE
Mailing Address - Street 2:STE 400-135
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423
Mailing Address - Country:US
Mailing Address - Phone:806-336-2705
Mailing Address - Fax:
Practice Address - Street 1:5424 19TH ST STE 200
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79407-2163
Practice Address - Country:US
Practice Address - Phone:806-722-4453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-28
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT6747208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics