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Mr. Shane Sullaway
Other Technician in Grand Prairie, Texas
NPI 1366738320

Shane Sullaway is a Other Technician based in Grand Prairie, TX. Shane Sullaway practices in Grand Prairie, TX. The NPI Number for Shane Sullaway is 1366738320 and holds a License No. (Texas).

The current practice location address for Shane Sullaway is 2100 N Highway 360, Grand Prairie, TX and can be reached out via phone at 972-647-8567 and via fax at 972-660-4548.

Location: 2100 N Highway 360, Grand Prairie, TX, 75050-1011
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1366738320
Provider Name
Shane Sullaway
Credential
Provider Entity Type
Individual
Gender
Male
Address
2100 N Highway 360, Grand Prairie, TX, 75050-1011
Phone Number
972-647-8567
Fax Number
972-660-4548
Provider Enumeration Date
06/28/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
247200000X 05 TX
institution
Provider Business Practice Location Address Details
Address
2100 N Highway 360
City
Grand Prairie
State
Texas
Zip
75050-1011
Phone Number
972-647-8567
Fax Number
972-660-4548
person
Provider Business Mailing Address Details
Address
2100 N Highway 360
City
Grand Prairie
State
Texas
Zip
75050-1011
Phone Number
972-647-8567
Fax Number
972-660-4548
person
Provider's Taxonomy Details 1
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Technician, Other
Speciality
-
Taxonomy
247200000X
License No.
()
Definition
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.
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