Provider Demographics
NPI:1104017979
Name:SHIRAZ P DHANANI PA
Entity Type:Organization
Organization Name:SHIRAZ P DHANANI PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIRAZ
Authorized Official - Middle Name:P
Authorized Official - Last Name:DHANANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-973-7445
Mailing Address - Street 1:1140 BUSINESS CENTER DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-2744
Mailing Address - Country:US
Mailing Address - Phone:713-973-7445
Mailing Address - Fax:713-973-9565
Practice Address - Street 1:1140 BUSINESS CENTER DR
Practice Address - Street 2:SUITE 500
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77043-2737
Practice Address - Country:US
Practice Address - Phone:713-973-7445
Practice Address - Fax:713-973-9565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0014QSOtherBLUE CROSS BLUE SHIELD
TX00530YMedicare PIN