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General NPI Number Information
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NPI Number | 1730164591
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Entity Type | Individual
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Provider Name | BRIAN JAY SHIMKUS MD
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Gender | Male
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Dates
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Enumeration Date | 12/14/2005
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Last Update Date | 07/14/2023
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Provider Practice Location Address
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Address Line | 3201 S AUSTIN AVE STE 315
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City | GEORGETOWN
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State | TX
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Zip | 78626-7642
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Country | US
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Telephone | 512-358-9428
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Fax | 737-710-1920
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Provider Business Mailing Address
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Address Line | PO BOX 749495
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City | ATLANTA
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State | GA
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Zip | 30374-9495
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Country | US
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Telephone | 394-328-3312
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Fax | 813-321-1296
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | L5907
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | L5907
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License Number State | TX
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