Individual
AARON IVY SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
855 MONTGOMERY, FORT WORTH, TX 76107-2553
(817) 884-3023
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M5923
TX
208M00000X
Hospitalist Physician
M5923
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
186054602
—
TX
05
—
186054603
—
TX
01
—
8DT140
BCBS
TX
Enumeration date
05/14/2007
Last updated
01/17/2014
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