1720047806 NPI number — DR. TAWHID A SHUAIB M.D.

Table of content: DR. TAWHID A SHUAIB M.D. (NPI 1720047806)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720047806 NPI number — DR. TAWHID A SHUAIB M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHUAIB
Provider First Name:
TAWHID
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1720047806
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/12/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4449
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MCALLEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78502-4449
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-362-8400
Provider Business Mailing Address Fax Number:
956-362-3651

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1801 S 5TH ST STE 114
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MCALLEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-362-8400
Provider Business Practice Location Address Fax Number:
956-362-3651
Provider Enumeration Date:
03/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  J9345 , 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: 119211401 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 119211404 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com