Provider Demographics
NPI:1194924076
Name:SHIFFLETTE, VANESSA KIANA (MD)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:KIANA
Last Name:SHIFFLETTE
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 1:221 W COLORADO BLVD
Mailing Address - Street 2:PAV 2, SUITE 425
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-2363
Mailing Address - Country:US
Mailing Address - Phone:214-947-3231
Mailing Address - Fax:214-947-3239
Practice Address - Street 1:221 W COLORADO BLVD
Practice Address - Street 2:PAV 2, SUITE 425
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-2363
Practice Address - Country:US
Practice Address - Phone:214-947-3231
Practice Address - Fax:214-947-3239
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP14932086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery