Individual provider · Type 1 NPI

Shane Sullaway

Other Technician · Grand Prairie, TX

NPI number 1366738320 Active

Practice location

2100 N Highway 360, Ste. 1802
Grand Prairie, TX 75050-1011

Call (972) 647-8567 Map

Fax (972) 660-4548

Specialties and licenses

TaxonomyCodeLicense
Other Technician Primary 247200000XNone listed

Other Technician: A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user.

3 other providers at this address

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About NPI 1366738320

Shane Sullaway's National Provider Identifier is 1366738320, issued on Jun 28, 2011. The primary taxonomy on file is Other Technician (247200000X), and the practice location is in Grand Prairie, TX. The record was last updated on Jun 28, 2011.