Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | T1557 | TX |
NPI | 1649657461 |
---|---|
Provider Name | Yushane Shih |
First Address | The Woodlands, TX 77384-4972 |
Second Address | The Woodlands, TX 77384-4972 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2015 |
Last Update Date | 31/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T1557 | STATE LICENSE (01) | TX |