Provider Demographics
NPI:1790197655
Name:SHEA, BRIAN JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JOSEPH
Last Name:SHEA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 S DALLAS PKWY STE 116
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TX
Mailing Address - Zip Code:75009-4297
Mailing Address - Country:US
Mailing Address - Phone:972-439-3753
Mailing Address - Fax:972-439-3754
Practice Address - Street 1:1530 S DALLAS PKWY STE 116
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:TX
Practice Address - Zip Code:75009-4297
Practice Address - Country:US
Practice Address - Phone:972-439-3753
Practice Address - Fax:972-439-3754
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU3651208600000X
OH35.136254208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery