Provider Demographics
NPI:1457009912
Name:LEUNG, SHANNON JEANIE (MD)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:JEANIE
Last Name:LEUNG
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
Mailing Address - Street 2:MEDICAL SCHOOL BUILDING (MSB) 6.018
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:713-500-7319
Practice Address - Street 1:6431 FANNIN ST
Practice Address - Street 2:MEDICAL SCHOOL BUILDING (MSB) 6.018
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-500-7337
Practice Address - Fax:713-500-7319
Is Sole Proprietor?:No
Enumeration Date:2022-03-14
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program