Organization Active NPI

Shaw Medical Center, PA

  • Family Medicine Physician
  • Burleson, TX
National Provider Identifier
1699977488
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SHAW MEDICAL CENTER, PA
Practice address
220 SW Wilshire Blvd
Burleson, TX 76028-4714
Phone
(817) 295-1121
Fax
(817) 295-8170
NPI assigned
Jun 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Robert H Shaw, MDNPI 1912989872
Title
President
Phone
(817) 295-1121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

220 SW Wilshire Blvd
Burleson, TX 76028-4714

Mailing address

220 SW Wilshire Blvd
Burleson, TX 76028-4714
Phone (817) 295-1121

Other identifiers 2

IdentifierTypeStateIssuer
CS3698OtherTXRAILROAD MEDICARE GROUP #
0080JKOtherTXBLUE SHIELD GROUP NUMBER

National Provider Directory

National Provider Directory

Locations

220 SW Wilshire Blvd
Burleson, TX 76028
Phone (817) 295-1121

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699977488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 SW WILSHIRE BLVD",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760284714",
            "telephone_number": "817-295-1121",
            "fax_number": "817-295-8170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 SW WILSHIRE BLVD",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760284714",
            "telephone_number": "817-295-1121",
            "fax_number": "817-295-8170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAW MEDICAL CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-295-1121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP #",
            "identifier": "CS3698",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP NUMBER",
            "identifier": "0080JK",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.