MEDICARE: DR. EDWARD ELMER SHUBERT 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	207W00000X	Ophthalmology Physician	E8173	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902807456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD ELMER SHUBERT MD

Provider Business Mailing Address
First Line	:	17070 RED OAK DRIVE
Second Line	:	#405
City	:	HOUSTON
State	:	TX
Zip	:	77090-2616
Country	:	US
Telephone Number	:	281-440-1500
Fax Number	:	281-440-0052

Provider Business Practice Location Address
First Line	:	17070 RED OAK DRIVE
Second Line	:	#405
City	:	HOUSTON
State	:	TX
Zip	:	77090-2616
Country	:	US
Telephone Number	:	281-440-1500
Fax Number	:	281-440-0052

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	06/16/2009

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