Provider Demographics
NPI:1356696744
Name:ALATTAR, SHAKIR M (MD)
Entity type:Individual
Prefix:DR
First Name:SHAKIR
Middle Name:M
Last Name:ALATTAR
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 1:17189 INTERSTATE HIGHWAY 45 S
Mailing Address - Street 2:MOB2 STE 105
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77385
Mailing Address - Country:US
Mailing Address - Phone:936-270-4971
Mailing Address - Fax:
Practice Address - Street 1:17189 I-45
Practice Address - Street 2:MOB2 STE 105
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77385
Practice Address - Country:US
Practice Address - Phone:936-270-4971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-21
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ1937207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine