Provider Demographics
NPI:1265233951
Name:HILL, SHALONDA
Entity type:Individual
Prefix:
First Name:SHALONDA
Middle Name:
Last Name:HILL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4233 HARTFORD DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-3216
Mailing Address - Country:US
Mailing Address - Phone:214-579-8955
Mailing Address - Fax:
Practice Address - Street 1:1610 S MALCOLM X BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75226-2101
Practice Address - Country:US
Practice Address - Phone:214-774-9700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist