Provider Demographics
NPI:1548226483
Name:HOMBAL, SHIRIL M (MD)
Entity Type:Individual
Prefix:
First Name:SHIRIL
Middle Name:M
Last Name:HOMBAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14275 MIDWAY RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3614
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:610-271-4245
Practice Address - Street 1:4770 REGENT BLVD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-2445
Practice Address - Country:US
Practice Address - Phone:972-934-4300
Practice Address - Fax:972-455-1212
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4652207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1548226483OtherNPI
TX8CK030OtherBCBS
TX1548226483OtherNPI