1790950541 NPI number — SHAHID JAMEEL MD PA

Table of content: (NPI 1790950541)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790950541 NPI number — SHAHID JAMEEL MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SHAHID JAMEEL MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790950541
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/09/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1759
Provider Second Line Business Mailing Address:
DEPT 952
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77251-1759
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-678-3539
Provider Business Mailing Address Fax Number:
832-678-3544

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11307 FM 1960 WEST
Provider Second Line Business Practice Location Address:
SUITE 350
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77065-3606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-678-3539
Provider Business Practice Location Address Fax Number:
832-678-3544
Provider Enumeration Date:
04/23/2008

Additional Information

Authorized Official

Authorized Official Last Name:
JAMEEL
Authorized Official First Name:
SHAHID
Authorized Official Middle Name:
Authorized Official Title or Position:
MD/OWNER
Authorized Official Telephone Number:
832-678-3539

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  M3591 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com