Provider Demographics
NPI:1336362789
Name:ILAMI, SHAHRFAR KASRAI (DC)
Entity Type:Individual
Prefix:DR
First Name:SHAHRFAR
Middle Name:KASRAI
Last Name:ILAMI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 S MCKINNEY ST
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-3338
Mailing Address - Country:US
Mailing Address - Phone:972-234-4646
Mailing Address - Fax:
Practice Address - Street 1:107 S MCKINNEY ST
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-3338
Practice Address - Country:US
Practice Address - Phone:972-234-4646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8139111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX609330Medicare ID - Type Unspecified