Provider Demographics
NPI:1710161070
Name:BEGUM, SHAHNAZ (MD)
Entity Type:Individual
Prefix:
First Name:SHAHNAZ
Middle Name:
Last Name:BEGUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2916 BEAUCHAMP DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093
Mailing Address - Country:US
Mailing Address - Phone:347-278-5184
Mailing Address - Fax:469-453-3232
Practice Address - Street 1:14688 STATE HIGHWAY 121 STE 120
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-4661
Practice Address - Country:US
Practice Address - Phone:469-910-5558
Practice Address - Fax:469-453-3232
Is Sole Proprietor?:No
Enumeration Date:2007-12-21
Last Update Date:2017-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0956207UN0901X, 207RC0000X
NY909846207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX276651YKP5Medicare PIN
TX276651YKQLMedicare PIN
TX276651YKPWMedicare PIN