1538488010 NPI number — ZUHAIR M. SHIHAB, M.D.,P.A.

Table of content: (NPI 1538488010)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538488010 NPI number — ZUHAIR M. SHIHAB, M.D.,P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ZUHAIR M. SHIHAB, M.D.,P.A.
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:
6
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:
1538488010
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/16/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4003 22ND ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LUBBOCK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79410-1115
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-792-3400
Provider Business Mailing Address Fax Number:
806-792-2023

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4003 22ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LUBBOCK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79410-1115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-792-3400
Provider Business Practice Location Address Fax Number:
806-792-2023
Provider Enumeration Date:
05/24/2010

Additional Information

Authorized Official

Authorized Official Last Name:
HENRY
Authorized Official First Name:
MALISA
Authorized Official Middle Name:
GAYE
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
806-792-3400

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  G2845 , 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)

  • Identifier: 282242101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 26TQ . This is a "BLUE CROSS BLUE SHIELD OF TEXAS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 40221784 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: DQ3589 . This is a "RAIILROAD MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 123895100 . This is a "FIRSTCARE" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".




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