Provider Demographics
NPI:1982629374
Name:SHAMSI, TARIQ S (MD)
Entity Type:Individual
Prefix:
First Name:TARIQ
Middle Name:S
Last Name:SHAMSI
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 1:2902 RIVER BIRCH PL
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79124-4972
Mailing Address - Country:US
Mailing Address - Phone:806-584-2281
Mailing Address - Fax:
Practice Address - Street 1:2601 DIMMITT RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072-1833
Practice Address - Country:US
Practice Address - Phone:806-296-5531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7610207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX113590712Medicaid
TXH07987Medicare UPIN
TX113590712Medicaid