Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | T1553 | TX |
N | 208600000X | Surgeon | T1553 | TX |
Y | 2086S0122X | Plastic and Reconstructive Surgery | T1553 | TX |
NPI | 1063807436 |
---|---|
Provider Name | Paul Luther Shay |
First Address | Houston, TX 77210-4439 |
Second Address | Houston, TX 77030-4000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2015 |
Last Update Date | 11/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
426202401 | (05) | TX |
426202402 | MEDICAID- CSHCN (01) | TX |
8PZ493 | BCBS (01) | TX |
Q00127415 | RAILROAD MEDICARE (01) | TX |