Provider Demographics
NPI:1821075300
Name:GALLIAN, SHAUNA MARKUS (CRNA)
Entity Type:Individual
Prefix:
First Name:SHAUNA
Middle Name:MARKUS
Last Name:GALLIAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:SHAUNA
Other - Middle Name:ESTES
Other - Last Name:MARKUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 840853
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0853
Mailing Address - Country:US
Mailing Address - Phone:972-233-1999
Mailing Address - Fax:972-233-3666
Practice Address - Street 1:6606 LBJ FWY STE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240
Practice Address - Country:US
Practice Address - Phone:972-715-5000
Practice Address - Fax:972-715-9976
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX440442367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX84953UOtherBCBS
TX160489402Medicaid
TXP00387542OtherRAILROAD
Q69821Medicare UPIN
TX8D2566Medicare PIN