MARILYN GENNEDY SHOOK (NPI# 1750582847) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1750582847 |
Entity Type | Individual |
Full Name | MARILYN GENNEDY SHOOK |
Credential | PA |
Practice Address |
18885 Katy Fwy Fl 2 Houston TX 77094-1103 |
Mailing Address |
Po Box 644006 Dallas TX 75264-4006 |
Practice Telephone | 2818292000 |
Mailing Telephone | 2818292000 |
Mailing Fax Number | 2818292220 |
Enumeration Date | 2007-05-29 |
Last Update Date | 2020-02-25 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363A00000X | Physician Assistant | PA05255 | TX | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA05255 | TX | Physician Assistants & Advanced Practice Nursing Providers |
N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA05255 | TX | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | MEDICARE INDIVIDUAL PTAN | 8J7704 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
5420 West Loop S Ste 2300, Bellaire, TX 774012118 | 7136506900 |
Street Address |
18885 KATY FWY FL 2 |
City | HOUSTON |
State | TX |
Zip Code | 77094-1103 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316591886 | John Walter Warner Jr. | Physical Therapist | 18200 Katy Fwy. Wa.0540.01, Houston, TX 77094 | 2019-08-01 |
1104394360 | Brooklyn Bradford | Physical Therapist | 18200 Katy Freeway, Wa 130, Houston, TX 77094 | 2018-11-06 |
1063921641 | Michelle Gorman | Chiropractor | 18021 Kingsland Blvd Apt 8103, Houston, TX 77094 | 2017-09-26 |
1558749705 | Sima Momin | Internal Medicine | 18400 Katy Fwy Ste 300, Houston, TX 77094 | 2015-05-08 |
1659784874 | Nova Pension | Behavioral Analyst | 19030 Waterford Cv, Houston, TX 77094 | 2014-06-05 |
1134531361 | Lina M Ching Mdpa | Internal Medicine | 18300 Katy Freeway, Suite 275, Houston, TX 77094 | 2014-05-22 |
1942610068 | Nesochi Adimorah | Obstetrics & Gynecology | 18400 Katy Fwy Ste 400, Houston, TX 77094 | 2014-04-28 |
1174952584 | Pure Smiles | Dentist | 19235 Katy Freeway South, 300a, Houston, TX 77094 | 2013-11-06 |
1134439086 | Monty Arta Aghazadeh | Surgery | 18300 Katy Fwy Ste 325, Houston, TX 77094 | 2010-10-13 |
1386972503 | Allan Sobrevians Garcia | Pharmacist | 18400 Katy Fwy Ste 100, Houston, TX 77094 | 2009-11-29 |
Find all providers in zip 77094 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619591864 | Today Telemedicine Pllc | Physician Assistant | 404 Oxford St Apt 2219, Houston, TX 77007-2679 | 2020-06-03 |
1114558335 | Erin Lynn Brown | Physician Assistant | 1504 Taub Loop Houston, Houston, TX 77030 | 2020-01-27 |
1720649478 | Teresa Garcia | Physician Assistant | 12911 Hawthorne Shores Dr, Houston, TX 77044-1258 | 2019-06-24 |
1407328578 | Brenda Guzman Castillo | Physician Assistant | 3003 Navigation Boulevard, Houston, TX 77003 | 2018-12-29 |
1518442649 | Alexander De Jesus Hadded | Physician Assistant | 3651 Weslayan St Ste 106, Houston, TX 77027-6643 | 2018-09-25 |
1003395872 | Silas Steven Luna | Physician Assistant | 427 W 20th St Ste 210, Houston, TX 77008-2400 | 2018-08-12 |
1619490901 | Dona Le | Physician Assistant | 11119 Fern Terrace Dr, Houston, TX 77075 | 2017-07-19 |
1043761455 | Lorena Michelle Sumner-nassif | Physician Assistant | 9809 Rowlett Rd # A1, Houston, TX 77075-3438 | 2016-10-20 |
1851760243 | Lauren K Duerst | Physician Assistant | 6550 Fannin St Ste 1701, Houston, TX 77030-2709 | 2015-09-16 |
1982081568 | Lundy Saing | Physician Assistant | 6431 Fannin St Msb 2.130, Houston, TX 77030 | 2015-05-02 |
Find all providers in HOUSTON |
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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.