Individual provider Active NPI

Albert Lovell Shaw, MD

  • Pain Medicine (Anesthesiology) Physician
  • Hurst, TX
National Provider Identifier
1073518833
Registry record updated Jul 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
D8080 Issued in TX
Practice address
729 West Bedfordeuless Road
Suite 111
Hurst, TX 76053
Phone
(817) 868-1109
Fax
(817) 545-8266
NPI assigned
Jun 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X D8080 TX Primary

Addresses

Primary practice location

729 West Bedfordeuless Road
Suite 111
Hurst, TX 76053

Mailing address

P.O. Box 780
Colleyville, TX 76034
Phone (817) 868-1109

Other identifiers 1

IdentifierTypeStateIssuer
0474496-01MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Total Pain Medicine Pain Medicine PastSince Aug 29, 2015 Accepting new patients
Total Pain Medicine & Anesthesiology PA Pain Medicine PastSince Apr 1, 2000 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1073518833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 780",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "76034",
            "telephone_number": "817-868-1109",
            "fax_number": "817-545-8266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 WEST BEDFORDEULESS ROAD",
            "address_2": "SUITE 111",
            "city": "HURST",
            "state": "TX",
            "postal_code": "76053",
            "telephone_number": "817-868-1109",
            "fax_number": "817-545-8266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "ALBERT",
        "middle_name": "LOVELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TX",
            "license": "D8080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0474496-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hurst, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.