Search › Texas › 207Q00000X
Shannel Pegram, DO
NPI 1710248653 · on the registry since 2012 · sole proprietor
Practice
- Address
- 1100 Wilford Hall Loop # 4554
Jbsa Lackland, TX 78236 - Phone
- (210) 292-6255
- Fax
- (210) 292-7934
- Clinicians at this address
- 5
Registry record
- Primary taxonomy
- 207Q00000X
207Q00000X
- Also registered as
- 2083X0100X
- Licence states on file
- NC
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2026-07-27
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas