Individual
SARAH CORNELIA SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1325 PENNSYLVANIA AVE STE 690, FORT WORTH, TX 76104-2133
(817) 761-7740
Mailing address
PO BOX 443, SANDERSON, TX 79848-0443
(410) 259-7862
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
R8481
TX
2086S0102X
Surgical Critical Care Physician
Primary
R8481
TX
2086S0127X
Trauma Surgery Physician
R8481
TX
Other
Enumeration date
03/29/2012
Last updated
10/05/2023
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