Provider Demographics
NPI:1457690679
Name:SHAMS, NAZANIN (PT)
Entity Type:Individual
Prefix:
First Name:NAZANIN
Middle Name:
Last Name:SHAMS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6213 SKYLINE DR
Mailing Address - Street 2:#200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-7036
Mailing Address - Country:US
Mailing Address - Phone:713-880-4400
Mailing Address - Fax:713-869-8637
Practice Address - Street 1:11621A KATY FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-1801
Practice Address - Country:US
Practice Address - Phone:832-399-5300
Practice Address - Fax:832-399-5301
Is Sole Proprietor?:No
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1226257225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist