Shannon Clinic

NPI 1770587149ActiveOrganization· Family Medicine· San Angelo, TX

Family Medicine in San Angelo, Texas, registered in NPPES in June 2005. The authorized official on file is Ricardo Villarreal, Coo. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.

Overview

NPI	1770587149
Status	Active
Entity type	Organization
NPI issued	Jun 13, 2005
Last updated in NPPES	Jul 14, 2025
Certified by provider	Jul 14, 2025

Specialties and licenses

Taxonomy	Code	License	State
Family Medicine Primary	207Q00000X	—	TX
Allergy & Immunology	207K00000X	—	TX
Allergy & Immunology, Allergy	207KA0200X	—	TX
Anesthesiology	207L00000X	—	TX
Dermatology	207N00000X	—	TX
Internal Medicine	207R00000X	—	TX
Neurological Surgery	207T00000X	—	TX
Obstetrics & Gynecology	207V00000X	—	TX
Ophthalmology	207W00000X	—	TX
Orthopaedic Surgery	207X00000X	—	TX
Otolaryngology	207Y00000X	—	TX
Pathology, Blood Banking & Transfusion Medicine	207ZB0001X	—	TX
Pediatrics	208000000X	—	TX
Radiology, Diagnostic Radiology	2085R0202X	—	TX
Surgery	208600000X	—	TX

About license numbers in NPPES

Exclusion screening

List	Result	Details
HHS-OIG LEIE · Oct 9, 2026	No match	Checked by NPI and by name + state
North Carolina Medicaid · Nov 4, 2026	No match	—
New York OMIG · Nov 4, 2026	No match	—
Ohio Medicaid · Nov 4, 2026	No match	—
Pennsylvania Medicheck · Nov 4, 2026	No match	—
Washington HCA · Nov 4, 2026	No match	—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)	Enrolled Part B Supplier - Clinic/Group Practice (CA); Part B Supplier - Clinic/Group Practice (CO); Part B Supplier - Clinic/Group Practice (FL); Part B Supplier - Clinic/Group Practice (GA); Part B Supplier - Clinic/Group Practice (HI); Part B Supplier - Clinic/Group Practice (ID); Part B Supplier - Clinic/Group Practice (IL); Part B Supplier - Clinic/Group Practice (KS); Part B Supplier - Clinic/Group Practice (MA); Part B Supplier - Clinic/Group Practice (MD); Part B Supplier - Clinic/Group Practice (MI); Part B Supplier - Clinic/Group Practice (MS); Part B Supplier - Clinic/Group Practice (NC); Part B Supplier - Clinic/Group Practice (NV); Part B Supplier - Clinic/Group Practice (OH); Part B Supplier - Clinic/Group Practice (OR); Part B Supplier - Clinic/Group Practice (PA); Part B Supplier - Clinic/Group Practice (SC); Part B Supplier - Clinic/Group Practice (TX); Part B Supplier - Clinic/Group Practice (UT); Part B Supplier - Clinic/Group Practice (VA); Part B Supplier - Clinic/Group Practice (WA)

Enrollment (PECOS)

Enrolled Part B Supplier - Clinic/Group Practice (CA); Part B Supplier - Clinic/Group Practice (CO); Part B Supplier - Clinic/Group Practice (FL); Part B Supplier - Clinic/Group Practice (GA); Part B Supplier - Clinic/Group Practice (HI); Part B Supplier - Clinic/Group Practice (ID); Part B Supplier - Clinic/Group Practice (IL); Part B Supplier - Clinic/Group Practice (KS); Part B Supplier - Clinic/Group Practice (MA); Part B Supplier - Clinic/Group Practice (MD); Part B Supplier - Clinic/Group Practice (MI); Part B Supplier - Clinic/Group Practice (MS); Part B Supplier - Clinic/Group Practice (NC); Part B Supplier - Clinic/Group Practice (NV); Part B Supplier - Clinic/Group Practice (OH); Part B Supplier - Clinic/Group Practice (OR); Part B Supplier - Clinic/Group Practice (PA); Part B Supplier - Clinic/Group Practice (SC); Part B Supplier - Clinic/Group Practice (TX); Part B Supplier - Clinic/Group Practice (UT); Part B Supplier - Clinic/Group Practice (VA); Part B Supplier - Clinic/Group Practice (WA)

Medicare sources and data years

Other Family Medicine providers in San Angelo

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Elisabeth Noelke MD PA
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IV League Health & Wellness
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1619728243
Ja Medical Services, PA
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1245061548
Pedro Castro
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1073081584
Regional Employee Assistance Program Inc
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1124080320
Shannon Rural Health Clinics, Inc
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1821289539
West Texas Medical Associates
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1457339525
Steven Alred, M.D.
San Angelo, TX · Individual
1326315128
Brad Richard Baker, MD
San Angelo, TX · Individual
1760460422

All Family Medicine providers in Texas →