Provider Demographics
NPI:1154513182
Name:SHANKLIN, CHRISTOPHER LANE (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:LANE
Last Name:SHANKLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11007 QUAKER AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-8317
Mailing Address - Country:US
Mailing Address - Phone:806-701-4040
Mailing Address - Fax:806-701-4041
Practice Address - Street 1:7601 QUAKER AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-3360
Practice Address - Country:US
Practice Address - Phone:806-725-9653
Practice Address - Fax:806-725-9600
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5920207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM67752381Medicaid
TXP00695621OtherRAILROAD MEDICARE
TX196357102Medicaid
TX196357102Medicaid