Provider Demographics
NPI:1497969323
Name:SHAMIM, AFROZ
Entity Type:Individual
Prefix:DR
First Name:AFROZ
Middle Name:
Last Name:SHAMIM
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 1:901 TURTLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-1947
Mailing Address - Country:US
Mailing Address - Phone:903-596-3588
Mailing Address - Fax:903-594-2038
Practice Address - Street 1:4101 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-6623
Practice Address - Country:US
Practice Address - Phone:903-266-2283
Practice Address - Fax:903-266-2398
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN66552084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry