Provider Demographics
NPI:1730195561
Name:SHIH, ELAINE M (OD)
Entity type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:M
Last Name:SHIH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 COUNTRY CLUB RD STE 120
Mailing Address - Street 2:
Mailing Address - City:ARGYLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-2358
Mailing Address - Country:US
Mailing Address - Phone:940-464-2020
Mailing Address - Fax:940-464-2021
Practice Address - Street 1:100 COUNTRY CLUB RD STE 120
Practice Address - Street 2:
Practice Address - City:ARGYLE
Practice Address - State:TX
Practice Address - Zip Code:76226-2358
Practice Address - Country:US
Practice Address - Phone:940-464-2020
Practice Address - Fax:940-464-2021
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6104T152W00000X, 152WV0400X, 152WC0802X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU87461Medicare UPIN