Provider Demographics
NPI:1669777272
Name:CLAWSON, SHANNA RENAE (PA-C)
Entity type:Individual
Prefix:
First Name:SHANNA
Middle Name:RENAE
Last Name:CLAWSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 S HAMPTON RD STE 900
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75224-1677
Mailing Address - Country:US
Mailing Address - Phone:214-330-9201
Mailing Address - Fax:214-339-9577
Practice Address - Street 1:2301 S HAMPTON RD STE 900
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75224-1677
Practice Address - Country:US
Practice Address - Phone:214-330-9201
Practice Address - Fax:214-339-9577
Is Sole Proprietor?:No
Enumeration Date:2011-01-13
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA07084363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical