Provider Demographics
NPI:1326422791
Name:SHAWN P TODD DO PA
Entity Type:Organization
Organization Name:SHAWN P TODD DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-639-1224
Mailing Address - Street 1:1704 E DENMAN AVE
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75901-6110
Mailing Address - Country:US
Mailing Address - Phone:936-639-1224
Mailing Address - Fax:936-632-9322
Practice Address - Street 1:1704 E DENMAN AVE
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75901-6110
Practice Address - Country:US
Practice Address - Phone:936-639-1224
Practice Address - Fax:936-632-9322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty