Provider Demographics
NPI:1912793191
Name:DILLARD, SHANERICKA DASHAEE (NHACPT)
Entity type:Individual
Prefix:
First Name:SHANERICKA
Middle Name:DASHAEE
Last Name:DILLARD
Suffix:
Gender:
Credentials:NHACPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8330 LYNDON B JOHNSON FWY STE 674
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-1332
Mailing Address - Country:US
Mailing Address - Phone:469-866-3173
Mailing Address - Fax:
Practice Address - Street 1:8330 LYNDON B JOHNSON FWY STE 674
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-1332
Practice Address - Country:US
Practice Address - Phone:469-866-3173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXY8E8L8D8246Y00000X, 246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health Information