Provider Demographics
NPI:1508024951
Name:SHI, ZHENG (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:ZHENG
Middle Name:
Last Name:SHI
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:ZHENG
Other - Middle Name:JANE
Other - Last Name:SHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:5219 CITY BANK PKWY STE 35
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-3545
Mailing Address - Country:US
Mailing Address - Phone:806-761-0333
Mailing Address - Fax:
Practice Address - Street 1:602 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79415-3364
Practice Address - Country:US
Practice Address - Phone:806-775-8600
Practice Address - Fax:806-775-8588
Is Sole Proprietor?:No
Enumeration Date:2008-06-01
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA003223207R00000X
TXP72082085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX325362701Medicaid
TX325362702OtherCSHCN MEDICAID
TX313574YK00Medicare PIN