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Individual
JOSEPH KYUNGHWAN SHIN
Active
Individual
JOSEPH KYUNGHWAN SHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP142418
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
407793501
—
TX
01
—
407793502
MEDICAID CSHCN
TX
01
—
8MH314
BCBS
TX
01
—
P02540105
RAILROAD MEDICARE
TX
Enumeration date
11/05/2019
Last updated
02/16/2023
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