Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Shane Sullaway

Individual provider Other Technician · NPI 1366738320

Mr. Shane Sullaway is an Other Technician in Grand Prairie, Texas. Registered with an NPI since 2011.

In the registry since
2011

Practice location Address checks out

2100 N Highway 360 Ste 1802
Grand Prairie, TX 75050-1011
Phone: (972) 647-8567
Fax: (972) 660-4548
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Other Technician (primary) Taxonomy 247200000X

Record details

NPI number1366738320
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 28, 2011
Last updated in NPPESJune 28, 2011
Mailing address2100 N Highway 360, Ste. 1802, Grand Prairie, TX 75050-1011

Other providers in Grand Prairie