Provider Demographics
NPI:1194171264
Name:XU, SHIN (MD)
Entity type:Individual
Prefix:
First Name:SHIN
Middle Name:
Last Name:XU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:403 OGLETREE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-9444
Mailing Address - Country:US
Mailing Address - Phone:936-755-3238
Mailing Address - Fax:936-755-3249
Practice Address - Street 1:403 OGLETREE DR STE 100
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-9444
Practice Address - Country:US
Practice Address - Phone:936-755-3238
Practice Address - Fax:936-755-3249
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXT7775207X00000X
MS28451207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery