Provider Demographics
NPI:1164423588
Name:SHAIBANI, AZIZ (MD)
Entity Type:Individual
Prefix:
First Name:AZIZ
Middle Name:
Last Name:SHAIBANI
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 1:6624 FANNIN ST STE 1670
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2340
Mailing Address - Country:US
Mailing Address - Phone:713-795-0033
Mailing Address - Fax:713-796-9302
Practice Address - Street 1:6624 FANNIN ST
Practice Address - Street 2:SUITE 1670
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2312
Practice Address - Country:US
Practice Address - Phone:713-795-0033
Practice Address - Fax:713-796-9302
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2010-07-01
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-06-27
Provider Licenses
StateLicense IDTaxonomies
TXJ50332084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0797425-01Medicaid
TX84030JMedicare ID - Type Unspecified
TXG41414Medicare UPIN
TX00062FMedicare ID - Type Unspecified