Shore, John W

Shore, John W is an individual health care provider with primary practice located at 3705 Medical Pkwy Suite 120, Austin TX 78705-1019. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Ophthalmic Plastic and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Ophthalmic Plastic and Reconstructive Surgery is his primary health care specialty. Shore, John W can be contacted via phone (512) 458-2141.

Contact Information

Primary practice address
3705 Medical Pkwy Suite 120 Austin TX 78705-1019
Phone: (512) 458-2141
Fax: (512) 458-4824
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X F2001 Texas
Allopathic & Osteopathic Physicians / Ophthalmic Plastic and Reconstructive Surgery 207WX0200X F2001 Texas

Profile Details

NPI number 1194716035
LBN Legal business name Shore, John W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2005
Last updated May 2nd, 2016 - about 8 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 1194716035 NPPES
Texas MEDICAID 124724903

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