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General NPI Number Information
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NPI Number | 1235560715
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Entity Type | Organization
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Legal Business Name | DAVID D SHIN, MD PA
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Dates
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Enumeration Date | 12/09/2013
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Last Update Date | 12/09/2013
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Provider Practice Location Address
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Address Line | 6550 FANNIN ST SUITE 2407
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City | HOUSTON
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State | TX
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Zip | 77030-2717
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Country | US
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Telephone | 713-790-0000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 372
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City | HOUSTON
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State | TX
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Zip | 77001-0372
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Country | US
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Telephone | 713-790-0000
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAVID D SHIN
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Credential | MD
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Telephone | 713-790-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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