John, Shine

John, Shine is an sole proprietor health care provider with primary practice located at 11614 Fm 2244 Rd Ste 150 , Austin TX 78738-5471. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. John, Shine can be contacted via phone (512) 399-5711.

Contact Information

Primary practice address
11614 Fm 2244 Rd Ste 150 Austin TX 78738-5471
Phone: (512) 399-5711
Fax: (512) 399-5707
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 016005365 Illinois
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 1910 Texas
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 1910 Texas

Profile Details

NPI number 1245407295
LBN Legal business name John, Shine
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 9th, 2008
Last updated Aug 16th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245407295 NPPES
Illinois Other 016005365 IL STATE LICENSE
Illinois Other 1910 IL STATE LICENSE

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