Provider Demographics
NPI:1407288467
Name:STOKER, SHONDON LASHON
Entity Type:Individual
Prefix:
First Name:SHONDON
Middle Name:LASHON
Last Name:STOKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12248 CHINA LAKE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75253-3045
Mailing Address - Country:US
Mailing Address - Phone:972-670-1082
Mailing Address - Fax:
Practice Address - Street 1:12248 CHINA LAKE DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75253-3045
Practice Address - Country:US
Practice Address - Phone:972-670-1082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-01
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency