Provider Demographics
NPI:1659744340
Name:KADIBHAI, SHABBIR Z
Entity Type:Individual
Prefix:
First Name:SHABBIR
Middle Name:Z
Last Name:KADIBHAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 ALMEDA RD APT 1125
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2131
Mailing Address - Country:US
Mailing Address - Phone:941-914-8211
Mailing Address - Fax:
Practice Address - Street 1:7100 ALMEDA RD APT 1125
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2131
Practice Address - Country:US
Practice Address - Phone:941-914-8211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX57382183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist