Shine Medical of Texas, P.a.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

SHINE MEDICAL OF TEXAS, P.A.

Practice address

2911 Turtle Creek Blvd Ste 300
Dallas, TX 75219-6243

Phone

(909) 442-0618

NPI assigned

Jul 19, 2022

Organization subpart

No

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

Authorized official

Name

Katherine Cassidy

Title

Clinical Operations Associate

Phone

(856) 287-8167

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1658188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663286400000",
    "number": "1154056695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 GRAND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100132614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 TURTLE CREEK BLVD STE 300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752196243",
            "telephone_number": "909-442-0618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINE MEDICAL OF TEXAS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-19",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A",
        "authorized_official_last_name": "CASSIDY",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "CLINICAL OPERATIONS ASSOCIATE",
        "authorized_official_telephone_number": "856-287-8167"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Shin, MD
• Sang Ho Shin, DMD
• Sangbin Shin
• Julie Shina, CPNP-AC
• Shine Bright Counseling and Consulting
• Shine Psychological Testing & Assessment Services
• Lorraine Shingledecker, LPC
• Shining Star Medical Massage Spa
• Aika Shinkawa, LPC-A
• Carolyn Victoria Shinn, MD

• Psychiatry Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; 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.