Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | R1878 | TX |
NPI | 1154610442 |
---|---|
Provider Name | Dr. John William Shuck |
First Address | Houston, TX 77070-4550 |
Second Address | Houston, TX 77070 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2011 |
Last Update Date | 08/01/2019 |