1841389020 NPI number — MANSOORA A SHEIKH MD

Table of content: MANSOORA A SHEIKH MD (NPI 1841389020)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841389020 NPI number — MANSOORA A SHEIKH MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHEIKH
Provider First Name:
MANSOORA
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1841389020
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/29/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11111 JONES RD
Provider Second Line Business Mailing Address:
STE # 3
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77070-6317
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-970-7797
Provider Business Mailing Address Fax Number:
281-970-7710

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11111 JONES RD
Provider Second Line Business Practice Location Address:
SUITE # 3
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77070-6317
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-970-7797
Provider Business Practice Location Address Fax Number:
281-970-7710
Provider Enumeration Date:
10/12/2006

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: 207R00000X , with the licence number:  M2097 , 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: 8S5947 . This is a "BCBS OF TEXAS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: P00254075 . This is a "RR MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 613060 . This is a "MEDICARE - INDIVIDUAL" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 179005701 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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