Individual
DR. STEPHANIE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
170 DEEPWOOD DR, SUITE 104, ROUND ROCK, TX 78681-4944
(512) 458-8400
(512) 458-8593
Mailing address
6500 NORTH MOPAC EXPRESSWAY, BUILDING 3, SUITE 200, AUSTIN, TX 78731
(512) 458-8400
(512) 458-8593
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
M6880
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8W4671
BCBS OF TEXAS INDIVIDUAL #
TX
Enumeration date
06/15/2007
Last updated
10/17/2008
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