Provider Demographics
NPI:1003346644
Name:GIRARDEAU, MIYSHA SHAW (MD, MS)
Entity Type:Individual
Prefix:DR
First Name:MIYSHA
Middle Name:SHAW
Last Name:GIRARDEAU
Suffix:
Gender:F
Credentials:MD, MS
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Mailing Address - Street 1:1504 TAUB LOOP
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1608
Mailing Address - Country:US
Mailing Address - Phone:713-870-3200
Mailing Address - Fax:713-873-3200
Practice Address - Street 1:1504 TAUB LOOP
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1608
Practice Address - Country:US
Practice Address - Phone:713-870-3200
Practice Address - Fax:713-873-3200
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN11019501A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS6041OtherTEXAS MEDICAL BOARD
IN11019501AOtherINDIANA PROFESSIONAL LICENSING AGENCY