Mr. Shane Sullaway
Mr. Shane Sullaway is an Other Technician in Grand Prairie, Texas. Registered with an NPI since 2011.
- In the registry since
- 2011
Practice location Address checks out
2100 N Highway 360 Ste 1802Grand Prairie, TX 75050-1011
Phone: (972) 647-8567
Fax: (972) 660-4548
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Other Technician (primary) | Taxonomy 247200000X |
|---|
Record details
| NPI number | 1366738320 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | June 28, 2011 |
| Last updated in NPPES | June 28, 2011 |
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