JERRELL WAYNE SHAW

MESQUITE, TX
NPI1659561470
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: TX  578398)
Enumeration Date2007-07-27
Last Update Date2007-12-18
Business Address
-- JERRELL WAYNE SHAW CRNA
3500 INTERSTATE 30 STE B240
MESQUITE, TX 75150-2685
Phone number: 972-681-7246
Mailing Address
-- JERRELL WAYNE SHAW CRNA
3500 INTERSTATE 30
MESQUITE, TX 75150-2651
Phone number: 972-681-7246
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