Provider Demographics
NPI:1497742746
Name:SHAMSEE, SYED SALEEM IQBAL-AHMED (MD)
Entity Type:Individual
Prefix:
First Name:SYED SALEEM
Middle Name:IQBAL-AHMED
Last Name:SHAMSEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BAYLOR PLZ STE NC100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3411
Mailing Address - Country:US
Mailing Address - Phone:713-798-3111
Mailing Address - Fax:713-798-7999
Practice Address - Street 1:20171 CHASEWOOD PARK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-1437
Practice Address - Country:US
Practice Address - Phone:713-798-3111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI50460207Q00000X
TXM8998207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34909600Medicaid
IA4261578Medicaid
WIP00432247Medicare PIN
IAI8378Medicare PIN
H64747Medicare UPIN
TX327436YMSKMedicare PIN
WI041854340Medicare PIN