Provider Demographics
NPI:1023503638
Name:GHAHREMANI, SHABNAM (DPT)
Entity type:Individual
Prefix:
First Name:SHABNAM
Middle Name:
Last Name:GHAHREMANI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 WINDY MEADOWS DR STE 102
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-1543
Mailing Address - Country:US
Mailing Address - Phone:210-858-9062
Mailing Address - Fax:210-566-3433
Practice Address - Street 1:133 WINDY MEADOWS DR STE 102
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-1543
Practice Address - Country:US
Practice Address - Phone:210-858-9062
Practice Address - Fax:210-566-3433
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3721225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist