Provider Demographics
NPI:1629277942
Name:THORNHILL, SHAUNA M (OD)
Entity Type:Individual
Prefix:DR
First Name:SHAUNA
Middle Name:M
Last Name:THORNHILL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 ABERDEEN DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-6429
Mailing Address - Country:US
Mailing Address - Phone:806-372-1977
Mailing Address - Fax:806-342-3029
Practice Address - Street 1:3700 E INTERSTATE 40
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79103
Practice Address - Country:US
Practice Address - Phone:806-372-1977
Practice Address - Fax:806-342-3029
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7077T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX01919748Medicaid
TX613095Medicare PIN