Provider Demographics
NPI:1356791115
Name:SHUAIB, WAQAS (MD)
Entity type:Individual
Prefix:DR
First Name:WAQAS
Middle Name:
Last Name:SHUAIB
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 1:1301 3RD ST STE 200
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-2245
Mailing Address - Country:US
Mailing Address - Phone:940-767-5145
Mailing Address - Fax:940-767-3027
Practice Address - Street 1:1301 3RD ST STE 200
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-2245
Practice Address - Country:US
Practice Address - Phone:940-767-5145
Practice Address - Fax:940-767-3027
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-13
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10056694207Q00000X
PAMD471322207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6905522Medicaid