Provider Demographics
NPI:1417930157
Name:MCLAUGHLIN, SHAUNA ADDISON (PA-C)
Entity Type:Individual
Prefix:
First Name:SHAUNA
Middle Name:ADDISON
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SHAUNA
Other - Middle Name:
Other - Last Name:ADDISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 4869
Mailing Address - Street 2:DEPT 594
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4869
Mailing Address - Country:US
Mailing Address - Phone:281-606-3100
Mailing Address - Fax:281-606-3102
Practice Address - Street 1:2950 CULLEN PARKWAY
Practice Address - Street 2:SUITE 202
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584
Practice Address - Country:US
Practice Address - Phone:281-606-3100
Practice Address - Fax:281-606-3102
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03451363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP68525Medicare UPIN