Shaw Pediatrics PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

E2856 Issued in TX

Legal business name

SHAW PEDIATRICS PA

Practice address

240 E Evergreen St
Sherman, TX 75090-5056

Phone

(903) 957-7429

Fax

(903) 957-7424

NPI assigned

Nov 5, 2013

Last updated

Nov 5, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Clyde Edward Shaw, M.D.NPI 1902824261

Title

President

Phone

(903) 957-7429

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Clyde E Shaw, MD

  • Pediatrics Physician
  • Sherman, TX
  • NPI 1902824261
  Authorized official Same address or phone

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383609600000",
    "number": "1871922310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 E EVERGREEN ST",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750905056",
            "telephone_number": "903-957-7429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 E EVERGREEN ST",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750905056",
            "telephone_number": "903-957-7429",
            "fax_number": "903-957-7424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAW PEDIATRICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-05",
        "last_updated": "2013-11-05",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "CLYDE",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-957-7429",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "E2856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129563606",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100155410A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joe David Shahan, LPT
• Mary Patricia Shahan, NP
• Chloe Sharker
• Patricia Sharkey, M.D.
• Rel Vincent Sharp, LPC
• Clyde E Shaw, MD
• Rahaf Ali Shawakfeh, SLPA
• Shawn Macdonald, M.D., P.a. (Sherman Medical)
• Mercedes Shea
• Lauri Shebesh, CNP-C

• Primary Care Clinic/Center in Sherman, TX
• Providers in Sherman, TX by specialty
• Primary Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.

Verify at the official NPI Registry.