Provider Demographics
NPI:1780683227
Name:SHAMI, MICHEL (MD)
Entity Type:Individual
Prefix:
First Name:MICHEL
Middle Name:
Last Name:SHAMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MICHEL
Other - Middle Name:JEAN
Other - Last Name:CHAMI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 650037
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0037
Mailing Address - Country:US
Mailing Address - Phone:214-696-2008
Mailing Address - Fax:
Practice Address - Street 1:4517 98TH STREET
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424
Practice Address - Country:US
Practice Address - Phone:806-792-0066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8830207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMX5853Medicaid
TX132679507Medicaid
P00199839Medicare PIN
NMX5853Medicaid
TX132679507Medicaid