Provider Demographics
NPI:1417284084
Name:JULIO SHAHAR MD PA
Entity Type:Organization
Organization Name:JULIO SHAHAR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-455-9030
Mailing Address - Street 1:13111 EAST FWY STE 304
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015-5819
Mailing Address - Country:US
Mailing Address - Phone:713-455-9030
Mailing Address - Fax:713-455-8956
Practice Address - Street 1:13111 EAST FWY STE 304
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-5819
Practice Address - Country:US
Practice Address - Phone:713-455-9030
Practice Address - Fax:713-455-8956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-03
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6954207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX139419915Medicaid
TX00K78POtherBLUE CROSS
TX00K78PMedicare UPIN