Provider Demographics
NPI:1356848063
Name:SHAKIR, STACIE ANN
Entity Type:Individual
Prefix:
First Name:STACIE
Middle Name:ANN
Last Name:SHAKIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 BLALOCK RD APT 32
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-7426
Mailing Address - Country:US
Mailing Address - Phone:832-449-6470
Mailing Address - Fax:
Practice Address - Street 1:9820 MEMORIAL DR APT 87
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-3443
Practice Address - Country:US
Practice Address - Phone:832-449-6470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-09
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker