Provider Demographics
NPI:1013383827
Name:SHAMA P QURAISHI MD PLLC
Entity Type:Organization
Organization Name:SHAMA P QURAISHI MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAMA
Authorized Official - Middle Name:P
Authorized Official - Last Name:QURAISHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-781-3698
Mailing Address - Street 1:5080 OAKMONT DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-7641
Mailing Address - Country:US
Mailing Address - Phone:409-832-7195
Mailing Address - Fax:409-832-8199
Practice Address - Street 1:2342 DOWLEN RD STE 102
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-2537
Practice Address - Country:US
Practice Address - Phone:409-832-7195
Practice Address - Fax:409-832-8199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1627207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty