Provider Demographics
NPI:1538665674
Name:SHINE, RYAN SPENCER
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:SPENCER
Last Name:SHINE
Suffix:
Gender:M
Credentials:
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 2975
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-2975
Mailing Address - Country:US
Mailing Address - Phone:956-362-8170
Mailing Address - Fax:956-362-8168
Practice Address - Street 1:1100 E DOVE AVE STE 300
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-4682
Practice Address - Country:US
Practice Address - Phone:956-362-8170
Practice Address - Fax:956-362-8168
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU6808208600000X, 2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery