Provider Demographics
NPI:1598773236
Name:ANDREW SHIMER, MD PA
Entity Type:Organization
Organization Name:ANDREW SHIMER, MD PA
Other - Org Name:CRAIG RANCH OB/GYN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:SHIMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-544-6600
Mailing Address - Street 1:7900 HENNEMAN WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070
Mailing Address - Country:US
Mailing Address - Phone:214-544-6600
Mailing Address - Fax:214-544-7770
Practice Address - Street 1:7900 HENNEMAN WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070
Practice Address - Country:US
Practice Address - Phone:214-544-6600
Practice Address - Fax:214-544-7770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080021101Medicaid
TX080021101Medicaid