Individual
ANDREW C. SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1401 MEDICAL PKWY STE 412, CEDAR PARK, TX 78613-5015
(512) 260-6050
(512) 260-6080
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-0813
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101254622
VA
207R00000X
Internal Medicine Physician
Q0699
TX
207RH0003X
Hematology & Oncology Physician
Primary
Q0699
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
338506401
—
TX
01
—
P01880005
RAILROAD
TX
Enumeration date
03/29/2010
Last updated
03/17/2018
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