Provider Demographics
NPI:1356849079
Name:MERCHANT, SHAMS (FNP)
Entity Type:Individual
Prefix:
First Name:SHAMS
Middle Name:
Last Name:MERCHANT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SHAMS
Other - Middle Name:
Other - Last Name:SANGLIWALLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:903 W MARTIN ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-0903
Mailing Address - Country:US
Mailing Address - Phone:210-358-9887
Mailing Address - Fax:210-358-5840
Practice Address - Street 1:903 W MARTIN ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207
Practice Address - Country:US
Practice Address - Phone:210-358-9887
Practice Address - Fax:210-358-5840
Is Sole Proprietor?:No
Enumeration Date:2018-01-28
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363LF0000X363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX392318702OtherCSHCN
TX392318701Medicaid
TX74-2712740Medicaid