Provider Demographics
NPI:1871985770
Name:SCOTT, SHON REESE (DC)
Entity type:Individual
Prefix:DR
First Name:SHON
Middle Name:REESE
Last Name:SCOTT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 SW AVENUE A
Mailing Address - Street 2:
Mailing Address - City:ANDREWS
Mailing Address - State:TX
Mailing Address - Zip Code:79714-7111
Mailing Address - Country:US
Mailing Address - Phone:432-355-6815
Mailing Address - Fax:
Practice Address - Street 1:205 SW AVENUE A
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:TX
Practice Address - Zip Code:79714-7111
Practice Address - Country:US
Practice Address - Phone:432-355-6815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12449111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor