Shannon Freeman, | |
4077 Jefferson Ave, Texarkana, AR 71854-1509 | |
(870) 330-9200 | |
Not Available |
Full Name | Shannon Freeman |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 4077 Jefferson Ave, Texarkana, Arkansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1144879404 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | A1908021 (Arkansas) | Secondary |
101YP2500X | Counselor - Professional | P2106003 (Arkansas) | Primary |
Entity Name | East Texas Border Health Clinic |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1093186249 PECOS PAC ID: 8820038565 Enrollment ID: O20170629001989 |
Mailing Address | Practice Location Address |
---|---|
Shannon Freeman, Po Box 1326, Marshall, TX 75671-1326 Ph: (903) 927-3782 | Shannon Freeman, 4077 Jefferson Ave, Texarkana, AR 71854-1509 Ph: (870) 330-9200 |
Terry Jerome Williams, LAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2904 Arkansas Blvd, Texarkana, AR 71854 Phone: 870-773-4655 Fax: 870-772-4650 | |
Carlotta A Powell, ADC,CS,PRSS Counselor Medicare: Not Enrolled in Medicare Practice Location: 7000 N Stateline Ave, Texarkana, AR 71854 Phone: 870-774-1315 | |
Angela Mckinney, Counselor Medicare: Not Enrolled in Medicare Practice Location: 701 Arkansas Blvd, Texarkana, AR 71854 Phone: 870-772-5028 | |
Anna M Mcbee, Counselor Medicare: Not Enrolled in Medicare Practice Location: 7000 N Stateline Ave, Texarkana, AR 71854 Phone: 870-774-1315 | |
George Ramser, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 701 Arkansas Blvd, Texarkana, AR 71854 Phone: 870-772-5028 Fax: 870-772-5056 | |
Shalundrea Lavaughn Cleveland, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4323 Jefferson Ave, Texarkana, AR 71854 Phone: 870-773-0700 Fax: 870-773-0705 | |
Rustin Green, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4323 Jefferson Ave, Texarkana, AR 71854 Phone: 870-773-0700 Fax: 870-773-0705 |