Dr. Ashley Gavin Shaw, D.O.
General Practice in Fort Sam Houston, TX. Individual provider (NPI-1).
NPI number1124348149
StatusActive
Last updated in NPPESMay 15, 2013
Details
- NPI
- 1124348149
- Entity type
- Individual (NPI-1)
- Name
- Dr. Ashley Gavin Shaw
- Credential
- D.O.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 2, 2010
- Last updated
- May 15, 2013
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | 005877 | AZ | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
3851 Roger Brooke DrMche-Qd (Creds)
Fort Sam Houston, TX 78234-4501
Phone 210-916-2460
Mailing address
3851 Roger Brooke DriveMche-Qd (Creds)
Fort Sam Houston, TX 78234-6200
Phone 210-916-2460
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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