Provider Demographics
NPI:1689696569
Name:SHMERLIN, INNA (MD,)
Entity Type:Individual
Prefix:
First Name:INNA
Middle Name:
Last Name:SHMERLIN
Suffix:
Gender:F
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:
Practice Address - Street 1:1441 N BECKLEY AVE STE 101
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203-1201
Practice Address - Country:US
Practice Address - Phone:972-943-9911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7559207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1909764Medicaid
TX8S3141OtherBLUE CROSS BLUE SHIELD
TXP00814805OtherRAILROAD MEDICARE
TX190976402Medicaid
TXP00814805OtherRAILROAD MEDICARE
TX8F3796Medicare PIN
TX8G8129Medicare PIN
TX8F5402Medicare PIN