Provider Demographics
NPI:1992148571
Name:CONNEELY, SHANNON E (MD)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:E
Last Name:CONNEELY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1102 BATES AVE
Mailing Address - Street 2:SUITE C1570
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2617
Mailing Address - Country:US
Mailing Address - Phone:832-824-4294
Mailing Address - Fax:832-825-9460
Practice Address - Street 1:1102 BATES AVE
Practice Address - Street 2:SUITE C1570
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2617
Practice Address - Country:US
Practice Address - Phone:832-824-4294
Practice Address - Fax:832-825-9460
Is Sole Proprietor?:No
Enumeration Date:2013-04-12
Last Update Date:2020-07-01
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Provider Licenses
StateLicense IDTaxonomies
TXQ7672208000000X, 2080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics