Provider Demographics
NPI:1215032594
Name:JONES, SHALITA MONIQUE (MD)
Entity Type:Individual
Prefix:DR
First Name:SHALITA
Middle Name:MONIQUE
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 GASTON AVE STE 550
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1905
Mailing Address - Country:US
Mailing Address - Phone:214-821-1177
Mailing Address - Fax:214-821-1193
Practice Address - Street 1:3600 GASTON AVE STE 550
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1905
Practice Address - Country:US
Practice Address - Phone:214-821-1177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA058356207R00000X
TXM4832208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8J3242OtherMEDICARE
TX1847204 01Medicaid
TXI71494Medicare UPIN