Provider Demographics
NPI:1033160858
Name:SHABOUT, NABEEL M (MD)
Entity Type:Individual
Prefix:DR
First Name:NABEEL
Middle Name:M
Last Name:SHABOUT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-2158
Mailing Address - Country:US
Mailing Address - Phone:817-332-9957
Mailing Address - Fax:817-336-3130
Practice Address - Street 1:3848 N TARRANT PKWY STE 100
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-5420
Practice Address - Country:US
Practice Address - Phone:817-753-6917
Practice Address - Fax:817-753-6921
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2023-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8502208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176759202Medicaid
TX8D6012Medicare ID - Type Unspecified