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

Shawn Jillian Waller, PA

Individual provider Physician Assistant · NPI 1669192373

Shawn Jillian Waller, PA is a Physician Assistant in Dallas, Texas. Graduated from Louisiana State University School of Medicine in Shreveport in 2022, 4 years ago. Practices with University of Texas Southwestern Medical Center at Dallas, a 3,149-clinician group and accepts Medicare assignment.

Years since qualifying
4
Trained at
Louisiana State University School of Medicine in Shreveport
In the registry since
2022
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

6201 Harry Hines Blvd
Dallas, TX 75390-0001
Phone: (214) 633-5555
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1669192373
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 1, 2022
Last updated in NPPESSeptember 1, 2022
Certification dateSeptember 1, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolLOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Graduated 2022 (4 years in practice)
Group practice University Of Texas Southwestern Medical Center At Dallas — 3149 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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