Provider Demographics
NPI:1851583611
Name:YARBROUGH, SHANNON DEE (MD)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:DEE
Last Name:YARBROUGH
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 1:5219 CITY BANK PKWY STE 35
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407
Mailing Address - Country:US
Mailing Address - Phone:806-761-0333
Mailing Address - Fax:806-782-0097
Practice Address - Street 1:3502 9TH ST STE 110
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79415-3367
Practice Address - Country:US
Practice Address - Phone:806-762-8461
Practice Address - Fax:806-761-0761
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2890207R00000X, 282NR1301X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No282NR1301XHospitalsGeneral Acute Care HospitalRural