Provider Demographics
NPI:1760688295
Name:WALKER, SHAYNA TANISE (MD)
Entity type:Individual
Prefix:DR
First Name:SHAYNA
Middle Name:TANISE
Last Name:WALKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22325 GOSLING RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77389-4409
Mailing Address - Country:US
Mailing Address - Phone:281-724-7980
Mailing Address - Fax:
Practice Address - Street 1:601 S HARBOUR ISLAND BLVD STE 109
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-5927
Practice Address - Country:US
Practice Address - Phone:813-212-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2025-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2011-019652084P0800X, 207Q00000X
CAA107393207Q00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5920366Medicaid
NCNC7241AOtherMEDICARE
NC172W0OtherBLUE CROSS BLUE SHILED OF NC
NC252985OtherMEDCOST, LLC
NC5920813Medicaid