Provider Demographics
NPI:1104818624
Name:JUNO, SHANNON M (MD)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:M
Last Name:JUNO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1720 VON MINDEN RD
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:TX
Mailing Address - Zip Code:78945-2419
Mailing Address - Country:US
Mailing Address - Phone:979-968-2700
Mailing Address - Fax:979-968-2733
Practice Address - Street 1:1720 VON MINDEN RD
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:TX
Practice Address - Zip Code:78945-2419
Practice Address - Country:US
Practice Address - Phone:979-968-2700
Practice Address - Fax:979-968-2733
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3444207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology