Provider Demographics
NPI:1871741900
Name:HYON CHRISTOPHER SHIN, M.D., P.A.
Entity type:Organization
Organization Name:HYON CHRISTOPHER SHIN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HYON-HO
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:SHIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-443-5954
Mailing Address - Street 1:9011 MOUNTAIN RIDGE DR STE 140
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-7369
Mailing Address - Country:US
Mailing Address - Phone:512-443-5954
Mailing Address - Fax:512-326-3433
Practice Address - Street 1:9011 MOUNTAIN RIDGE DR STE 140
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-7369
Practice Address - Country:US
Practice Address - Phone:512-443-5954
Practice Address - Fax:512-326-3433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX354064301Medicaid
TX0007WKOtherBCBS
TX031274601Medicaid
TX031274601Medicaid