Provider Demographics
NPI:1114943156
Name:SHIH, EDWIN CHUCK (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:CHUCK
Last Name:SHIH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 4346
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4346
Mailing Address - Country:US
Mailing Address - Phone:210-485-1844
Mailing Address - Fax:210-399-2730
Practice Address - Street 1:16607 BLANCO RD
Practice Address - Street 2:SUITE 303
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1913
Practice Address - Country:US
Practice Address - Phone:210-485-1844
Practice Address - Fax:210-399-2730
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL8955207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8W6542OtherBLUE CROSS BLUE SHIELD
TX8F4317Medicaid
TX168363302Medicaid
TX8F4317Medicaid