Active NPI
Charles Shaw
- Prescribing (Medical) Psychologist
- Houston, TX
National Provider Identifier
1851633044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prescribing (Medical) Psychologist
- License
- D8430
- Practice address
- 4118 Blossom St
Houston, TX 77007-5711 - Phone
- (713) 863-8511
- NPI assigned
- Mar 26, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prescribing (Medical) Psychologist | 103TP0016X | D8430 | TX | Primary |
Addresses
Primary practice location
4118 Blossom St
Houston, TX 77007-5711
Mailing address
4118 Blossom St
Houston, TX 77007-5711
Phone (713) 863-8511
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D8430 | TX | MD | Prescribing (Medical) Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364256000000",
"number": "1851633044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4118 BLOSSOM ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770075711",
"telephone_number": "713-863-8511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4118 BLOSSOM ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770075711",
"telephone_number": "713-863-8511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "CHARLES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-03-26",
"last_updated": "2013-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TP0016X",
"taxonomy_group": "",
"desc": "Psychologist, Prescribing (Medical)",
"state": "TX",
"license": "D8430",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.