Provider Demographics
NPI:1073010724
Name:ALSHEBANI, QAISAR (DO)
Entity Type:Individual
Prefix:
First Name:QAISAR
Middle Name:
Last Name:ALSHEBANI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DELL SETON MEDICAL CENTER-IM 1500 RED RIVER RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701
Mailing Address - Country:US
Mailing Address - Phone:512-324-8355
Mailing Address - Fax:
Practice Address - Street 1:UT AUSTIN DELL MEDICAL SCHOOL
Practice Address - Street 2:DELL SETON MEDICAL CENTER 1500 RED RIVER RD
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78712
Practice Address - Country:US
Practice Address - Phone:512-324-8355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10063737207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine