Provider Demographics
NPI:1487695953
Name:SHI, HONG (MD)
Entity type:Individual
Prefix:DR
First Name:HONG
Middle Name:
Last Name:SHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3019 GOROM CT
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-9718
Mailing Address - Country:US
Mailing Address - Phone:832-802-6018
Mailing Address - Fax:
Practice Address - Street 1:2101 CRAWFORD ST
Practice Address - Street 2:300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8942
Practice Address - Country:US
Practice Address - Phone:713-861-2022
Practice Address - Fax:713-861-2234
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5906225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
05678388OtherECFMG
H76291Medicare UPIN
8G2016Medicare ID - Type Unspecified