Provider Demographics
NPI:1225160245
Name:DUNNIGAN, SHAWN LAWRENCE (OD)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:LAWRENCE
Last Name:DUNNIGAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 SOUTH MAIN
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:TX
Mailing Address - Zip Code:77657-7358
Mailing Address - Country:US
Mailing Address - Phone:409-751-3937
Mailing Address - Fax:409-751-3131
Practice Address - Street 1:875 SOUTH MAIN ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:TX
Practice Address - Zip Code:77657-7358
Practice Address - Country:US
Practice Address - Phone:409-751-3937
Practice Address - Fax:409-751-3131
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4638-TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU35636Medicare UPIN
TX00E84VMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER