Individual
KIM RAY SHRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18545 W LAKE HOUSTON PKWY, HUMBLE, TX 77346-3392
(281) 812-4000
(281) 812-3331
Mailing address
18545 W LAKE HOUSTON PKWY, HUMBLE, TX 77346-3392
(281) 812-4000
(281) 812-3331
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
L2649
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145199904
—
TX
05
—
145199905
—
TX
01
—
21210202328
BEECHSTREET
—
01
—
4119904
CIGNA
—
01
—
4198390001
DME PALMETTO
—
01
—
4198390002
DME PALMETTO
—
01
—
5248990
CCN FIRST HEALTH
—
01
—
7114117
AETNA
—
01
—
8B7450
BLUE CROSS BLUE SHIELD
TX
01
—
975250
ONE HEALTH PLAN
—
Enumeration date
10/17/2005
Last updated
11/27/2023
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