| Shaw Pediatrics PA | |
|
240 E Evergreen St Sherman TX 75090-5056 | |
| (903) 957-7429 | |
| (903) 957-7424 |
| Full Name | Shaw Pediatrics PA |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 240 E Evergreen St, Sherman, Texas |
| Authorized Official Name and Position | Clyde Edward Shaw (PRESIDENT) |
| Authorized Official Contact | 9039577429 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shaw Pediatrics PA 240 E Evergreen St Sherman TX 75090-5056 Ph: (903) 957-7429 | Shaw Pediatrics PA 240 E Evergreen St Sherman TX 75090-5056 Ph: (903) 957-7429 |
| NPI Number | 1871922310 |
|---|---|
| Provider Enumeration Date | 11/05/2013 |
| Last Update Date | 11/05/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871922310 | NPI | - | NPPES |
| 129563606 | Medicaid | TX | |
| 100155410A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | E2856 (Texas) | Primary |
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