Provider Demographics
NPI:1699161356
Name:SWEENEY, SHANE PATRICK (MD)
Entity type:Individual
Prefix:
First Name:SHANE
Middle Name:PATRICK
Last Name:SWEENEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3551 ROGER BROOKE DR
Mailing Address - Street 2:
Mailing Address - City:FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4504
Mailing Address - Country:US
Mailing Address - Phone:210-916-4224
Mailing Address - Fax:210-916-3235
Practice Address - Street 1:101 E RIDGE RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1847
Practice Address - Country:US
Practice Address - Phone:956-632-6000
Practice Address - Fax:956-632-6641
Is Sole Proprietor?:No
Enumeration Date:2015-04-09
Last Update Date:2024-06-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101261309207ZP0102X
TXT4472207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology