Provider Demographics
NPI:1437713096
Name:MADBULY, SHAIMAA
Entity Type:Individual
Prefix:
First Name:SHAIMAA
Middle Name:
Last Name:MADBULY
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 1:1333 OLD SPANISH TRL APT 3110
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1862
Mailing Address - Country:US
Mailing Address - Phone:347-440-6811
Mailing Address - Fax:
Practice Address - Street 1:1333 OLD SPANISH TRL APT 3110
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1862
Practice Address - Country:US
Practice Address - Phone:347-440-6811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-29
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist