1831283696 NPI number — BING SHI M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831283696 NPI number — BING SHI M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

SHI

Provider First Name:

BING

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1831283696

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

10/21/2008

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 5865

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

LUBBOCK

Provider Business Mailing Address State Name:

TX

Provider Business Mailing Address Postal Code:

79408-5865

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

806-743-2898

Provider Business Mailing Address Fax Number:

806-743-2787

Provider First Line Business Practice Location Address:

3601 4TH ST

Provider Second Line Business Practice Location Address:

SUITE 1C282

Provider Business Practice Location Address City Name:

LUBBOCK

Provider Business Practice Location Address State Name:

TX

Provider Business Practice Location Address Postal Code:

79430-8182

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

806-743-2981

Provider Business Practice Location Address Fax Number:

806-743-2984

Provider Enumeration Date:

10/03/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207L00000X , with the licence number:  20008 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
• Taxonomy code: 207L00000X , with the licence number: L8192 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

• Identifier: 101170100 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: 101170100 . This is a "FIRSTCARE COMMERCIAL" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
• Identifier: 159048102 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: 202006951 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
• Identifier: 87355Z . This is a "HMO BLUE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
• Identifier: 202006951 . This is a "PRESBYTERIAN COMMERCIAL" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
• Identifier: 55487866 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
• Identifier: A567 . This is a "TRIWEST" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
• Identifier: 159048101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: 200011200A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
• Identifier: 8F0119 . This is a "BC/BS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
• Identifier: P00622804 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".