Provider Demographics
NPI:1528391406
Name:MARY N. SHINN, M.D., P.A.
Entity Type:Organization
Organization Name:MARY N. SHINN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:NATALIE
Authorized Official - Last Name:SHINN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-522-4411
Mailing Address - Street 1:1200 BINZ ST STE 1190
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-6926
Mailing Address - Country:US
Mailing Address - Phone:713-522-4411
Mailing Address - Fax:713-522-5588
Practice Address - Street 1:1200 BINZ ST STE 1190
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-6926
Practice Address - Country:US
Practice Address - Phone:713-522-4411
Practice Address - Fax:713-522-5588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-10
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8414208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00F03TOtherMEDICARE
TX1326130279OtherNPI INDIVIDUAL IDENTIFIER
TX00F03TOtherMEDICARE