Individual
KI Y. SHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
K6324
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
250009806
RR MEDICARE
TX
05
—
43811101
—
TX
01
—
83182S
BCBS
TX
Enumeration date
09/15/2006
Last updated
07/05/2012
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