SHANNON L WATTS (NPI# 1114009578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114009578 |
Entity Type | Individual |
Full Name | SHANNON L WATTS |
Credential | MD |
Practice Address |
1540 Southtown Dr Ste 104 Granbury TX 76048-2682 |
Mailing Address |
Po Box 99371 Fort Worth TX 76199-0371 |
Practice Telephone | 8172791390 |
Practice Fax Number | 8175735150 |
Mailing Telephone | 6828851855 |
Mailing Fax Number | 6828857347 |
Enumeration Date | 2006-10-19 |
Last Update Date | 2010-04-19 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208000000X | Pediatrics | J6048 | TX | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | AETNA PIN | 5618256 | 01 |
TX | BCBSTX GRP PIN | 00U87Z | 01 |
TX | UHC PIN | 1399858 | 01 |
TX | 140442860 | 05 | |
TX | CIGNA PIN | 3447654 | 01 |
TX | BCBSTX IND PIN | 87013G | 01 |
TX | CCHIP PIN | WATSG13439 | 01 |
TX | FIRSTCARE PIN | 126490101 | 01 |
TX | 137072802 | 05 | |
GRP NPI NUMBER | 1750369203 | 01 | |
TX | FIRSTHEALTH PIN | 965043 | 01 |
TX | 117559805 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023678620 | Shannon Lynn Watts | Physician Assistant | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2019-06-17 |
1881050300 | Shannon Watts | Social Worker | 40 Summer St, Bangor, ME 04401-7144 | 2016-01-13 |
1457635526 | Shannon Eller Watts | Physician Assistant | 2002 Medical Pkwy Ste 500, Annapolis, MD 21401-3268 | 2011-10-06 |
1891022927 | Shannon Watts | Speech-Language Pathologist | 169 Tequesta Dr, Suite 24e, Tequesta, FL 33469-2768 | 2009-11-10 |
1184838906 | Shannon K Watts | Family Medicine | 1340 Hal Greer Boulevard, Attn: Tammie Silva, Huntington, WV 25701-3800 | 2007-05-10 |
Street Address |
1540 SOUTHTOWN DR STE 104 |
City | GRANBURY |
State | TX |
Zip Code | 76048-2682 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215928767 | Michael Bryant Stroud | Dermatology | 1540 Southtown Dr, Suite 107, Granbury, TX 76048-2682 | 2005-11-03 |
1982753299 | Dme Solutions Lp | Durable Medical Equipment & Medical Supplies | 1540 Southtown Dr, Suite 101, Granbury, TX 76048-2682 | 2007-01-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689213415 | Tena Lee Wood I | Licensed Practical Nurse | 302 S. Crites Granbury Tx. 76048, 302 S. Crites Granbury Tx. 76048, Granbury, TX 76048 | 2019-12-26 |
1811456593 | Laura Nicole Graham | Counselor | 2101 West Pearl Street, Granbury, TX 76048 | 2019-03-13 |
1477000974 | Globalrehab - Fort Worth, Lp | Rehabilitation Hospital | 805 Hill Blve, Ste 109, Granbury, TX 76048 | 2016-09-01 |
1780130245 | Rachel Diane Rouse | Counselor | 1903 W Pearl Street, Granbury, TX 76048 | 2016-08-25 |
1477946648 | Adriana Brown | Nurse Practitioner | 805 Hill Blvd., #104, Granbury, TX 76048 | 2015-03-12 |
1407261233 | Rogers King Coleman | General Practice | 1411 Crawford Street, Granbury, TX 76048 | 2014-07-01 |
1891115176 | Trinity Nursing and Rehabilitation of Granbury, Lp | Skilled Nursing Facility | 600 Reunion Court, Granbury, TX 76048 | 2014-04-24 |
1639507122 | Kayelen Helton | Counselor | 807 Paluxy Road, Granbury, TX 76048 | 2013-10-22 |
1013257799 | Pecan Valley Mhmr Region | Counselor | 2101 W. Pearl St., Granbury, TX 76048 | 2013-02-18 |
1114240223 | Talbot Green Mccormick Jr. | General Practice | 2306 Cologne Dr., Granbury, TX 76048 | 2010-03-03 |
Find all providers in zip 76048 |
Taxonomy Code | 208000000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760667547 | Laura G Power Md Pa | Pediatrics | 1305 Paluxy Rd Ste B, Granbury, TX 76048-5641 | 2007-12-30 |
1225226657 | Wendy Heger Bonnell | Pediatrics | 9222 Monticello Dr, Granbury, TX 76049-4502 | 2007-10-10 |
1700099207 | Granbury Pediatrics & Associates | Pediatrics | 805 Paluxy Rd, Granbury, TX 76048-2329 | 2007-05-08 |
1164504577 | David B Steinmann | Pediatrics | 3906 E Us Highway 377, Ste 110, Granbury, TX 76049-7609 | 2006-10-19 |
1659392058 | Laura G Power | Pediatrics | 1308 Paluxy Rd Ste 301, Granbury, TX 76048-5609 | 2006-07-21 |
1205181302 | Saloni Sharma Paudel | Pediatrics | 1315 Waters Edge Dr Ste 101, Granbury, TX 76048 | 2012-07-16 |
1154506566 | Delia I. Wright, Md, Pa | Pediatrics | 1305 Paluxy Rd Ste B, Granbury, TX 76048-5641 | 2008-01-03 |
1972608636 | Lake Granbury Internal Medicine & Pediatrics, Pa | Pediatrics | 2005 Rockview Drive, Granbury, TX 76049 | 2006-09-14 |
1568490423 | Delia Irene Wright | Pediatrics | 1305 Paluxy Rd, Ste. B, Granbury, TX 76048-5641 | 2006-06-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598366635 | Colleen Jaurequi | Pediatrics | 309 Shepards Hill Dr, Rockwall, TX 75087-2850 | 2020-11-05 |
1114526050 | 915 Pediatrics Pllc | Pediatrics | 3261 Joe Battle Blvd, El Paso, TX 79936-1156 | 2020-10-21 |
1114525532 | Springs Pediatrics Associates Pllc | Pediatrics | 201 Oak Dr S Ste 202, Lake Jackson, TX 77566-5627 | 2020-10-16 |
1619575487 | Sreebhavi Professional Corporation | Pediatrics | 340 Hawkins Run Rd, Midlothian, TX 76065-6638 | 2020-10-14 |
1588262695 | Buttercup Pediatrics Pllc | Pediatrics | 27524 Westridge Creek Ln Ste D, Katy, TX 77494-5290 | 2020-10-12 |
1851908131 | Cesar A Ortega Md Pa | Pediatrics | 3309 Orlando St, Houston, TX 77093-4854 | 2020-09-30 |
1992310973 | Fernando Castaneda Md Pa | Pediatrics | 4151 Jaime Zapata Hwy Suite 102, Laredo, TX 78043 | 2020-09-15 |
1497368591 | Tch Pediatrics Inc | Pediatrics | 4207 James Casey St Ste 111, Austin, TX 78745-3362 | 2020-08-28 |
1356951735 | Central Texas Diabetes & Wellness Institute | Pediatrics | 8428 Bandera Rd Ste 2, San Antonio, TX 78250-2514 | 2020-07-31 |
1306455530 | Z-pediatrics Pllc | Pediatrics | 5886 Dezavala Rd Suite 101 #510, San Antonio, TX 78249 | 2020-07-23 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.