Provider Demographics
NPI:1639250434
Name:SAIYED, SHABBIR I (MD)
Entity Type:Individual
Prefix:
First Name:SHABBIR
Middle Name:I
Last Name:SAIYED
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 1:1501 E MOCKINGBIRD LN
Mailing Address - Street 2:#101
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-2155
Mailing Address - Country:US
Mailing Address - Phone:361-513-6291
Mailing Address - Fax:361-576-2434
Practice Address - Street 1:1501 E MOCKINGBIRD LN
Practice Address - Street 2:#101
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-2155
Practice Address - Country:US
Practice Address - Phone:361-513-6291
Practice Address - Fax:361-576-2434
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6712207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115971701Medicaid
TX742710179A024OtherCHAMPUS
TX87W153OtherBLUE CROSS
TX742710179A024OtherCHAMPUS
TX87W153Medicare PIN
TX050053902Medicare ID - Type UnspecifiedRAILROAD
TX050053902Medicare ID - Type UnspecifiedRAILROAD