Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | M9546 | TX |
Y | 207RP1001X | Pulmonary Disease | M9546 | TX |
NPI | 1013105816 |
---|---|
Provider Name | Dr. Shawn Pua Eiko Nishi |
First Address | Galveston, TX 77555-5302 |
Second Address | Galveston, TX 77555-5302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2007 |
Last Update Date | 24/01/2020 |