Shaina McCullough, PA-C
Physician Assistant in Austin, TX. Individual provider (NPI-1).
NPI number1164080685
StatusActive
Last updated in NPPESJun 10, 2024
Details
- NPI
- 1164080685
- Entity type
- Individual (NPI-1)
- Name
- Shaina McCullough
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 30, 2019
- Certification date
- Jun 10, 2024
- Last updated
- Jun 10, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA12984 | TX | Yes |
Practice location
11209 S Interstate 35Austin, TX 78747-1712
Phone 512-654-4700
Mailing address
Po Box 844658Dallas, TX 75284-4658
Phone 254-724-2111
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