Provider Demographics
NPI:1245790112
Name:GASKIN, SHONNA (MD)
Entity Type:Individual
Prefix:
First Name:SHONNA
Middle Name:
Last Name:GASKIN
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 1:6431 FANNIN ST RM 5.170
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1501
Mailing Address - Country:US
Mailing Address - Phone:713-500-6113
Mailing Address - Fax:713-500-0648
Practice Address - Street 1:6431 FANNIN ST RM 5.170
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:713-500-6113
Practice Address - Fax:713-500-0648
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program