MEDICARE: DR. JUDI SHAW-RICE MD, FACP, MMM, CPE

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	207RA0000X	Adolescent Medicine (Internal Medicine) Physician	J1134	TX
2	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	J1134	TX
3	207R00000X	Internal Medicine Physician	J1134	TX

General Provider Information

NPI Number	:	1437253093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUDI SHAW-RICE MD, FACP, MMM, CPE

Provider Business Mailing Address
First Line	:	1127 ELDRIDGE PKWY STE 300-342
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-1771
Country	:	US
Telephone Number	:	713-665-7423
Fax Number	:	281-920-2600

Provider Business Practice Location Address
First Line	:	1127 ELDRIDGE PKWY STE 300-342
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-1771
Country	:	US
Telephone Number	:	713-665-7423
Fax Number	:	281-920-2600

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

Provider Enumeration Date	:	09/12/2006
Last Update Date	:	10/04/2018

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