Provider Demographics
NPI:1124019260
Name:PARVEZ, SHABANA (MD)
Entity Type:Individual
Prefix:
First Name:SHABANA
Middle Name:
Last Name:PARVEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHABANA
Other - Middle Name:
Other - Last Name:VALI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4135 CASCADE SKY DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76005-1103
Mailing Address - Country:US
Mailing Address - Phone:817-404-5004
Mailing Address - Fax:877-405-1116
Practice Address - Street 1:4135 CASCADE SKY DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76005
Practice Address - Country:US
Practice Address - Phone:682-256-2749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7506207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188377901Medicaid
TX8AA312OtherBCBS
TXP00879699OtherRRMCARE THRU HEB
TX188377906Medicaid
NM54007267Medicaid
TX8AB545OtherBCBSTX
TX8K0147Medicare PIN
TX188377906Medicaid
TX188377901Medicaid