Organization
CHARLES B SHUEY JR MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES B. SHUEY M.D. (PRESIDENT)
(214) 384-3734
Entity
Organization
Contact information
Practice address
3600 GASTON AVE, SUITE 210, DALLAS, TX 75246-1800
(214) 796-3439
(877) 720-0539
Mailing address
3701 JUNIUS ST # B010, DALLAS, TX 75246-2026
(214) 796-3439
(877) 720-0539
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
C9136
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120409101
—
TX
01
—
TXB112955
MEDICARE BILLING PTAN
TX
Enumeration date
03/19/2010
Last updated
11/27/2011
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