Individual
SHAWN TAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
115 MEDICAL CIR STE 106, ATHENS, TX 75751
(903) 675-1322
(903) 675-6743
Mailing address
PO BOX 731912, DALLAS, TX 75373-1912
(903) 877-7635
(903) 877-7754
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
R5044
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102G70337
MEDICARE GROUP PTAN
AL
05
—
150833
—
AL
05
—
151223
—
AL
01
—
511-37500
BCBS OF AL
AL
01
—
511-38669
BCBS OF AL
AL
Enumeration date
06/02/2008
Last updated
07/18/2019
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