Provider Demographics
NPI:1225575244
Name:SHAWN TASSONE MD PHD PLLC
Entity type:Organization
Organization Name:SHAWN TASSONE MD PHD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRAMONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-973-9222
Mailing Address - Street 1:505 W LOUIS HENNA BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728-1701
Mailing Address - Country:US
Mailing Address - Phone:512-956-0296
Mailing Address - Fax:512-777-4527
Practice Address - Street 1:505 W LOUIS HENNA BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78728-1701
Practice Address - Country:US
Practice Address - Phone:512-956-0296
Practice Address - Fax:512-777-4527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-28
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty