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1851616916
SHANNA KIDD
ODESSA, TX
NPI
1851616916
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Former Name
SHANNA JO WHEATLEY
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: TX PA06691)
Enumeration Date
2010-04-01
Last Update Date
2010-11-12
Business Address
-- SHANNA KIDD PA-C
701 W 5TH ST
ODESSA, TX 79763-4206
Phone number: 432-335-1500
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Mailing Address
-- SHANNA KIDD PA-C
701 W 5TH ST SUITE 1C34
ODESSA, TX 79763-4206
Phone number: 432-335-5126
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