MR. SHANE SULLAWAY
NPI 1366738320
Technician, Other in Grand Prairie, TX

Q: What is Shane Sullaway's NPI number?

The NPI number for Shane Sullaway is 1366738320. It was assigned to this individual provider in the NPPES registry on June 28, 2011.

Q: What is Shane Sullaway's specialty?

The primary specialty registered for this NPI is Technician, Other with taxonomy code 247200000X.

Q: When was this NPI record last updated?

The NPPES record for Shane Sullaway was last updated on June 28, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 28, 2011

2100 N HIGHWAY 360, STE. 1802, GRAND PRAIRIE, TX 75050(972) 647-8567(972) 660-4548 Get Directions Write a Review

NPPES record last updated: June 28, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mr. Shane Sullaway NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. SHANE SULLAWAY (NPI 1366738320) is an individual technician, other provider in Grand Prairie, Texas and active in the NPI registry since June 2011.

NPPES Registry Identity

NPI1366738320

Entity TypeIndividualMale

Primary Taxonomy247200000X

Provider Legal NameMR. SHANE SULLAWAY

Location Address2100 N HIGHWAY 360, STE. 1802Grand Prairie, TX 75050-1011

Mailing Address2100 N Highway 360, Ste. 1802Grand Prairie, TX 75050-1011

Phone(972) 647-8567

Fax(972) 660-4548

Sole ProprietorNo

Enumeration DateJune 28, 2011

✔ NPI 1366738320 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyTechnician, OtherTechnologists, Technicians & Other Technical Service Providers

Taxonomy Code247200000X

Definition

A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user.

2100 N HIGHWAY 360, Grand Prairie, TX 75050

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Other Identifiers 1

Medicaid247200000XTX

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STELLAR HEALTHCARE SERVICES, LLC

Case Manager/Care Coordinator

2100 N HIGHWAY 360, SUITE 1105
GRAND PRAIRIE, TX 75050

Dallas County (214) 412-3528

DICKSON KUTEY

Durable Medical Equipment & Medical Supplies

2100 N HIGHWAY 360, SUITE 301
GRAND PRAIRIE, TX 75050

Dallas County (972) 641-1612

MR. GARY RODGERS ATP

Technician, Other

2100 N HIGHWAY 360, SUITE 1802
GRAND PRAIRIE, TX 75050

Dallas County (972) 647-8567

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shane Sullaway's NPI number?

The NPI number for Shane Sullaway is 1366738320. It was assigned to this individual provider in the NPPES registry on June 28, 2011.

Where is Shane Sullaway located?

Shane Sullaway practices at 2100 N Highway 360 Ste. 1802, Grand Prairie, TX 75050. The listed phone number is (972) 647-8567.

What is Shane Sullaway's specialty?

The primary specialty registered for this NPI is Technician, Other with taxonomy code 247200000X.

When was this NPI record last updated?

The NPPES record for Shane Sullaway was last updated on June 28, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.