MEDICARE: DR. TIANA M SHIVER 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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	H2780	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00T68N	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1851470223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIANA M SHIVER MD

Provider Business Mailing Address
First Line	:	909 FROSTWOOD DR STE 1.100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-2301
Country	:	US
Telephone Number	:	713-338-6353
Fax Number	:	713-704-3086

Provider Business Practice Location Address
First Line	:	6400 FANNIN ST STE 2015
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1531
Country	:	US
Telephone Number	:	832-658-4050
Fax Number	:

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

Provider Enumeration Date	:	11/04/2006
Last Update Date	:	03/12/2020

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