Provider Demographics
NPI:1306040795
Name:OHARROW, SHEA (DC)
Entity Type:Individual
Prefix:
First Name:SHEA
Middle Name:
Last Name:OHARROW
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 BRODIE LN # 620-132
Mailing Address - Street 2:
Mailing Address - City:SUNSET VALLEY
Mailing Address - State:TX
Mailing Address - Zip Code:78745-2538
Mailing Address - Country:US
Mailing Address - Phone:512-731-1588
Mailing Address - Fax:512-459-0533
Practice Address - Street 1:4631 AIRPORT BLVD STE 130
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78751-3442
Practice Address - Country:US
Practice Address - Phone:512-450-0533
Practice Address - Fax:512-459-0533
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8626111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor