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Organization
SHAW MEDICAL CENTER, PA
Active
Organization
SHAW MEDICAL CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT H SHAW MD (PRESIDENT)
(817) 295-1121
Entity
Organization
Contact information
Practice address
220 SW WILSHIRE BLVD, BURLESON, TX 76028-4714
(817) 295-1121
(817) 295-8170
Mailing address
220 SW WILSHIRE BLVD, BURLESON, TX 76028-4714
(817) 295-1121
(817) 295-8170
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0080JK
BLUE SHIELD GROUP NUMBER
TX
01
—
CS3698
RAILROAD MEDICARE GROUP #
TX
Enumeration date
06/04/2007
Last updated
08/22/2020
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