Provider Demographics
NPI:1104387430
Name:SHAW, SHA'RAY (MD)
Entity Type:Individual
Prefix:DR
First Name:SHA'RAY
Middle Name:
Last Name:SHAW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5375 COIT RD STE 130
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-4914
Mailing Address - Country:US
Mailing Address - Phone:214-619-1910
Mailing Address - Fax:214-619-1914
Practice Address - Street 1:5375 COIT RD STE 130
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-4914
Practice Address - Country:US
Practice Address - Phone:142-619-1910
Practice Address - Fax:214-619-1914
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-28
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU49302084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty