Provider Demographics
NPI:1649867391
Name:RODRIGUEZ, SHANALY RAMIREZ (DC)
Entity type:Individual
Prefix:DR
First Name:SHANALY
Middle Name:RAMIREZ
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S ZANG BLVD STE 1210
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-6624
Mailing Address - Country:US
Mailing Address - Phone:972-232-2227
Mailing Address - Fax:
Practice Address - Street 1:400 S ZANG BLVD STE 1210
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-6624
Practice Address - Country:US
Practice Address - Phone:972-232-2227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14603111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor