Provider Demographics
NPI:1679917694
Name:SHAHNAWAZ, ZAINAB
Entity type:Individual
Prefix:
First Name:ZAINAB
Middle Name:
Last Name:SHAHNAWAZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6513 PRESTON RD STE 300
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2694
Mailing Address - Country:US
Mailing Address - Phone:214-216-6564
Mailing Address - Fax:214-385-2574
Practice Address - Street 1:6513 PRESTON RD STE 300
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2694
Practice Address - Country:US
Practice Address - Phone:214-216-6564
Practice Address - Fax:214-385-2574
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-21
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT2065207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1679917694Medicaid