Provider Demographics
NPI:1790727709
Name:O'SHAUGHNESSY, JOYCE ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:ANN
Last Name:O'SHAUGHNESSY
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:3410 WORTH ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2003
Practice Address - Country:US
Practice Address - Phone:214-370-1000
Practice Address - Fax:214-370-1809
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3366207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX129007402Medicaid
TX129007401Medicaid
TX129007404Medicaid
TX8R1519OtherBLUE CROSS OF TEXAS
TX129007404Medicaid
TX129007401Medicaid
TX84W422Medicare PIN
TX8R1519OtherBLUE CROSS OF TEXAS
TX8A2451Medicare PIN
TX88221KMedicare PIN