Provider Demographics
NPI:1740200013
Name:FURR, SHAWN RENEA (LPT)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:RENEA
Last Name:FURR
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 HIGHWAY 78 N.
Mailing Address - Street 2:
Mailing Address - City:FARMERSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75442
Mailing Address - Country:US
Mailing Address - Phone:972-784-6533
Mailing Address - Fax:972-782-8415
Practice Address - Street 1:1022 HIGHWAY 78 N.
Practice Address - Street 2:
Practice Address - City:FARMERSVILLE
Practice Address - State:TX
Practice Address - Zip Code:75442
Practice Address - Country:US
Practice Address - Phone:972-784-6533
Practice Address - Fax:972-782-8415
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1065126225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0008MROtherGROUP BCBS
TX8T4271OtherIND. BCBS
TX00033ZMedicare ID - Type UnspecifiedGROUP MEDICARE #
TX8T4271OtherIND. BCBS
TX8F0433Medicare ID - Type UnspecifiedPROVIDER ID #