MEDICARE: SAMUEL SHENG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	J1391	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	89240S	OTHER	TX	BCBSTX IND PIN
2	1750369203	OTHER		GRP NPI NUMBER
3	5208023	OTHER	TX	AETNA PIN
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	3864022	OTHER		ECFMG PIN
6	SHESF47936	OTHER	TX	CCHIP PIN
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	00U87Z	OTHER	TX	BCBSTX GRP PIN
9	1305238	OTHER	TX	UHC PIN
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	828135	OTHER	TX	FIRSTHEALTH PIN
12	8563120	OTHER	TX	CIGNA PIN

General Provider Information

NPI Number	:	1669554077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL SHENG MD

Provider Business Mailing Address
First Line	:	PO BOX 99371
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76199-0371
Country	:	US
Telephone Number	:	682-885-1855
Fax Number	:	682-885-7347

Provider Business Practice Location Address
First Line	:	1525 S COOPER ST
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76010-4105
Country	:	US
Telephone Number	:	817-804-1100
Fax Number	:	817-299-8790

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	04/21/2010

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Directions to “ SAMUEL SHENG MD” Practice Location

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