Provider Demographics
NPI:1790970192
Name:BENOY, SHANNON LEIGH
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:LEIGH
Last Name:BENOY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 LAKE HILL LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-7457
Mailing Address - Country:US
Mailing Address - Phone:214-740-3604
Mailing Address - Fax:
Practice Address - Street 1:1901 LAKE HILL LN
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-7457
Practice Address - Country:US
Practice Address - Phone:214-740-3604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-09
Last Update Date:2007-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist