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:
Health care specialties
Specialty | Code | License # | 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 2 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1245407295 | NPPES |
Illinois | Other | 016005365 | IL STATE LICENSE |
Illinois | Other | 1910 | IL STATE LICENSE |
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