Provider Demographics
NPI:1861498743
Name:ALLAWALA, SHAHZAD SAEED (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAHZAD
Middle Name:SAEED
Last Name:ALLAWALA
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:P.O. BOX 687
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75123
Mailing Address - Country:US
Mailing Address - Phone:972-709-7556
Mailing Address - Fax:972-709-7611
Practice Address - Street 1:407 N. CEDER RIDGE
Practice Address - Street 2:SUITE 230
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116
Practice Address - Country:US
Practice Address - Phone:972-709-7556
Practice Address - Fax:972-709-7611
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-24
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-43032084P0800X
TXM79712084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR440110001Medicaid
TX440110001Medicaid
AR440110001Medicaid
TXTXB107234Medicare Oscar/Certification