Provider Demographics
NPI:1356861389
Name:THARANI, SHAMSHAD (FNP)
Entity Type:Individual
Prefix:
First Name:SHAMSHAD
Middle Name:
Last Name:THARANI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 58794
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-8794
Mailing Address - Country:US
Mailing Address - Phone:281-724-4711
Mailing Address - Fax:281-724-1861
Practice Address - Street 1:500 N KOBAYASHI STE A
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4722
Practice Address - Country:US
Practice Address - Phone:281-724-4711
Practice Address - Fax:281-724-1861
Is Sole Proprietor?:No
Enumeration Date:2017-06-21
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133663363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily