Provider Demographics
NPI:1396220539
Name:SHI, CHUAN
Entity Type:Individual
Prefix:
First Name:CHUAN
Middle Name:
Last Name:SHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 E STASSNEY LN APT 1323
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-3483
Mailing Address - Country:US
Mailing Address - Phone:737-217-5041
Mailing Address - Fax:
Practice Address - Street 1:501 E STASSNEY LN APT 1323
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-3483
Practice Address - Country:US
Practice Address - Phone:737-217-5041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist