Provider Demographics
NPI:1245557396
Name:SHIUE, ANGELA BONNIE (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:BONNIE
Last Name:SHIUE
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 1:5413 CRENSHAW RD
Mailing Address - Street 2:STE 400
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-3143
Mailing Address - Country:US
Mailing Address - Phone:713-943-2800
Mailing Address - Fax:
Practice Address - Street 1:5413 CRENSHAW RD
Practice Address - Street 2:STE 400
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-3143
Practice Address - Country:US
Practice Address - Phone:713-943-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-29
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP6272207R00000X, 207RC0000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX355393501Medicaid
TX355393501Medicaid