Healthcare Provider Details

I. General information

NPI: 1790721967
Provider Name (Legal Business Name): DANIEL SHIH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 08/21/2020
Certification Date: 08/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 NORTH MOPAC SUITE 420
AUSTIN TX
78731
US

IV. Provider business mailing address

4301 W. WILLIAM CANNON DRIVE STE B 150 #273
AUSTIN TX
78749
US

V. Phone/Fax

Practice location:
  • Phone: 512-482-0045
  • Fax: 512-476-9892
Mailing address:
  • Phone: 512-358-0949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberL8954
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberM-14510
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: