Basic Information
Provider Information
NPI: 1396949533
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REID
FirstName: SHAUNA
MiddleName: SEXTON
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1380 RIVER BEND DR
Address2: METROCARE SERVICES
City: DALLAS
State: TX
PostalCode: 752474914
CountryCode: US
TelephoneNumber: 2147436159
FaxNumber:  
Practice Location
Address1: 400 N ALLEN DR STE 103
Address2:  
City: ALLEN
State: TX
PostalCode: 750132564
CountryCode: US
TelephoneNumber: 9728857515
FaxNumber: 9727673735
Other Information
ProviderEnumerationDate: 06/12/2007
LastUpdateDate: 04/13/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/13/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800XM6848TXN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
2084P0804XM6848TXY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry

No ID Information.


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