Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | R8481 | TX |
Y | 208600000X | Surgeon | R8481 | TX |
N | 2086S0102X | Surgical Critical Care | R8481 | TX |
N | 2086S0127X | Trauma Surgeon | R8481 | TX |
NPI | 1073889523 |
---|---|
Provider Name | Sarah Cornelia Shaw |
First Address | Sanderson, TX 79848-0443 |
Second Address | Danville, PA 17822 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2012 |
Last Update Date | 30/08/2018 |