Shaw, Timothy Shane
Shaw, Timothy Shane is an individual health care provider with primary practice located at 601 Ogeltree Dr. Suite D, Livingston TX 77351. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Shaw, Timothy Shane can be contacted via phone (936) 328-8080.Contact Information
Primary practice address
601 Ogeltree Dr. Suite D
Livingston TX 77351
Phone: (936) 328-8080
Fax: (936) 328-8505
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | M1343 | Texas |
Profile Details
| NPI number | 1316930183 |
|---|---|
| LBN Legal business name | Shaw, Timothy Shane |
| Credentials | M.D., P.A. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 26th, 2005 |
| Last updated | Oct 12th, 2007 - about 17 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 | 1316930183 | NPPES |
| Louisiana | MEDICAID | 1788538 | |
| Louisiana | Other | P00256091 |
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