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Individual

SHAWN TITTLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4201 GARTH RD, SUITE 211, BAYTOWN, TX 77521-3167
(832) 556-6046
(281) 428-4720
Mailing address
4201 GARTH RD, SUITE 211, BAYTOWN, TX 77521-3167
(832) 556-6046
(281) 428-4720

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
042777
CT
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
042777
CT
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
R0798
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001427774
CT
01
8GK557
BCBS
TX
Enumeration date
07/09/2006
Last updated
01/16/2017
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