Individual
KIM RAY SHRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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