Provider Demographics
NPI:1326054552
Name:SHI, WENLIANG (MD)
Entity Type:Individual
Prefix:
First Name:WENLIANG
Middle Name:
Last Name:SHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 MIDWAY RD
Mailing Address - Street 2:SUITE 169
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8471
Mailing Address - Country:US
Mailing Address - Phone:214-256-9666
Mailing Address - Fax:214-256-9888
Practice Address - Street 1:3100 MIDWAY RD
Practice Address - Street 2:SUITE 169
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8471
Practice Address - Country:US
Practice Address - Phone:214-256-9666
Practice Address - Fax:214-256-9888
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4714207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
8A0803Medicare ID - Type Unspecified
H66909Medicare UPIN