Provider Demographics
NPI:1275087686
Name:SHI, JEREMY ZEMING (BS, MPH)
Entity Type:Individual
Prefix:MR
First Name:JEREMY
Middle Name:ZEMING
Last Name:SHI
Suffix:
Gender:M
Credentials:BS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 WHITE SETTLEMENT RD APT 48
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-1129
Mailing Address - Country:US
Mailing Address - Phone:713-518-6690
Mailing Address - Fax:
Practice Address - Street 1:3900 WHITE SETTLEMENT RD APT 48
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-1129
Practice Address - Country:US
Practice Address - Phone:713-518-6690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-15
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X
TXU1766390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No174H00000XOther Service ProvidersHealth Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX891234242OtherBACHELOR OF SCIENCE