Provider Demographics
NPI:1225241938
Name:FEATHERSTON, SHANNON JILL (DC)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:JILL
Last Name:FEATHERSTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 SPARROW PT
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76133-6725
Mailing Address - Country:US
Mailing Address - Phone:972-392-3400
Mailing Address - Fax:972-392-3499
Practice Address - Street 1:1905 ABRAMS RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75214-3916
Practice Address - Country:US
Practice Address - Phone:972-392-3400
Practice Address - Fax:972-392-3499
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4153111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor